Treating acute osteomyelitis
Acute osteomyelitis can usually be successfully treated using antibiotics
These medicines are usually given as a six-week course. For part of the treatment course you will need to take the medicine intravenously (directly into a vein).
Depending on your general state of health, you may need to stay in hospital during this time. Otherwise, you may be able to receive the injections as an outpatient (where you go home the same day). You will usually be able to switch to tablets for the rest of the treatment course once you are well.
In cases of osteomyelitis, there is usually a choice of antibiotics available to treat the infection and often two antibiotics are used in combination. This is known as dual therapy.
Occasionally, the bacteria causing the infection are resistant to standard antibiotics and less-frequently-used antibiotics are needed.
All antibiotics have side effects, which you should discuss with your GP or the doctor in charge of your care.
A much less common cause of osteomyelitis is a fungal infection.
In cases of fungal osteomyelitis, an antifungal medication called voriconazole is usually the treatment of choice.
Treating chronic osteomyelitis
People with chronic osteomyelitis will usually require a combination of antibiotics medication and surgery to remove any damaged bone. A surgeon may need to make an incision (cut) near the site of the infection to drain away any pus.
If there is extensive bone damage, it will be necessary to surgically remove any diseased bone and tissue. This procedure is known as debridement. Debridement can often leave an empty space in the bone, which is sometimes packed with antibiotic-loaded cement. If the surgeon does this, a second operation will be required to remove the cement within a few weeks of the first. Not all centres use cement and no difference is found in the clearance of infection.
In some cases, it may also be necessary to transfer muscle and skin from another part of the body to repair the tissue surrounding the affected bone.
Hyperbaric oxygen therapy
Some researchers have argued that a type of non-surgical treatment called hyperbaric oxygen therapy may be useful in treating cases of both acute and chronic osteomyelitis that do not respond to conventional treatment.
During hyperbaric oxygen therapy, you are placed in a specially designed chamber that is similar to a decompression chamber used by divers.
The chamber is filled with oxygen, which is administered at a much higher pressure (hyperbaric) than the normal level of oxygen in the atmosphere. The high levels of oxygen are thought to speed up the healing process and slow the spread of infection.
There is currently only limited evidence supporting the effectiveness of hyperbaric oxygen therapy for treating osteomyelitis. From the evidence available, it would appear that it is most effective in treating osteomyelitis associated with a diabetic foot ulcer.
