Materiały źródłowe

• #1 Osteomyelitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532250/

  With aggressive early treatment, the prognosis of acute osteomyelitis is good. […] Various measures used to prevent postoperative infections include good preoperative preparation where possible and the use of surgical rooms with laminar airflow. Recommended also is the use of prophylactic preoperative antibiotic treatment administered parenterally 30 minutes before skin incision with first-generation (cefazolin) or second-generation cephalosporins (cefuroxime). All these measures have been shown to decrease the rate of postoperative infections from 0.5% to 2%, thereby improving patient outcomes.

• #1 Osteomyelitis

  https://navicenthealth.org/service-center/orthopaedic-trauma-institute/osteomyelitis

  The most effective way to prevent an infection of the bone like osteomyelitis is to treat any type of skin or wound infections properly. A minor skin wound needs to be carefully cleaned and covered with a sterile bandage. Any sign of infection should be cause for concern. This includes swelling, pain, discharge, redness and more. Any deep wound or bone injury needs immediate medical attention.

• #1 Osteomyelitis (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/osteomyelitis.html

  One way to prevent osteomyelitis is to keep skin clean. All cuts and wounds especially deep wounds should be cleaned well. Wash a wound with soap and water, holding it under running water for at least 5 minutes to flush it out. […] To keep the wound clean afterward, cover it with sterile gauze or a clean cloth. You can apply an over-the-counter antibiotic cream, but the most important thing is to keep the area clean. Wounds should begin healing within 24 hours and completely heal within a week. A wound that takes longer to heal or causes extreme pain should be checked by a doctor. […] Wash your hands well and often to stop the spread of germs. Also be sure that your vaccinations are up to date.

• #1 Osteomyelitis (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/osteomyelitis.html

  One way to prevent osteomyelitis is to keep skin clean. All cuts and wounds especially deep wounds should be cleaned well. Wash a wound with soap and water, holding it under running water for at least 5 minutes to flush it out. […] To keep the wound clean afterward, cover it with sterile gauze or a clean cloth. You can apply an over-the-counter antibiotic cream, but the most important thing is to keep the area clean. Wounds should begin healing within 24 hours and completely heal within a week. A wound that takes longer to heal or causes extreme pain should be checked by a doctor. […] Parents and kids should wash their hands well and often to stop the spread of germs. Kids also should have their vaccinations kept up to date.

• #1 Osteomyelitis (Bone Infection): Causes, Symptoms & Treatment – Smile Avenue Family Dentistry

  https://www.smileavenuefamilydentistry.com/osteomyelitis-bone-infection-causes-symptoms-treatment/

  Preventing osteomyelitis involves taking steps to prevent infections in general, such as practicing good hygiene, cleaning and properly caring for wounds, and managing chronic health conditions that can increase the risk of infection. […] Understanding the risk factors of osteomyelitis is crucial for prevention and early detection. People with compromised immune systems, those with chronic illnesses such as diabetes, or individuals who have recently undergone surgical procedures have a higher risk of developing osteomyelitis. Poor blood circulation, smoking, and illegal drug use can also increase the risk. […] Questions to ask your doctor about osteomyelitis include: How can I best prevent future infections?

• #1 Osteomyelitis: A Bone-a-fide Overview of Risk Factors, Prevention, and Treatment

  https://afmc.org/blog/osteomyelitis

  Preventive measures include good foot care for diabetic patients, such as daily foot inspections, wearing socks and well-fitting shoes, and managing blood sugar levels to minimize complications that could lead to infections. […] Good foot care is extremely important for patients with diabetes. Diabetic neuropathy can make it difficult for our patients with diabetes to feel cuts, scrapes, or other common foot injuries. Untreated, these abrasions may get infected and turn into something more serious. […] I recommend my patients with diabetes inspect their feet every single day, Dr. Novack says. They should be wearing socks and well-fitting shoes as much as possible. Even a small injury from stepping on a rock, for instance, can lead to a wound that eventually invades the bone. […] Keeping blood sugar under control can also decrease the risk of neuropathy and blood vessel problems that contribute to these injuries.

• #1 Osteomyelitis: Symptoms, Causes, and Treatment

  https://www.webmd.com/diabetes/osteomyeltis-treatment-diagnosis-symptoms

  The best way to prevent osteomyelitis is to keep things clean. If you or your child has a cut, especially a deep cut, wash it completely. Flush out any open wound under running water for five minutes, then bandage it in sterile bandages. […] If you have chronic osteomyelitis, make sure your doctor knows about your medical history so you can work together to keep the condition under control. If you have diabetes, pay close attention to your feet and contact your doctor at the first sign of infection. […] The sooner you treat osteomyelitis, the better. In cases of acute osteomyelitis, early treatment prevents the condition from becoming a chronic problem that requires ongoing treatment. Besides the pain and inconvenience of repeated infections, getting osteomyelitis under control early provides the best chance for recovery.

• #1 Osteomyelitis: Symptoms, causes, complications, and treatment

  https://www.medicalnewstoday.com/articles/178819

  To prevent osteomyelitis, doctors recommend: […] for people with diabetes, having prompt medical care for any issues involving the feet […] for people with peripheral neuropathy, always wearing shoes, to prevent wounds.

• #1 Osteomyelitis – Treatments

  https://mydoctor.kaiserpermanente.org/mas/structured-content/Treatment_Osteomyelitis_-_Treatments.xml?co=/regions/mas

  Osteomyelitis is a bone infection. It is caused by bacteria or a fungus. […] It’s important to diagnosis osteomyelitis early and treat it with antibiotics. This helps: Lower the risk of infection spreading to other bones or tissues. Prevent chronic osteomyelitis problems. […] Our first goal is to prevent osteomyelitis from spreading. […] Self-care is important for healing. Follow these guidelines: Take your medications as prescribed. Carefully follow the self-care instructions we give to you. Keep the IV attachment site clean at all times, if you’re receiving antibiotics by IV. Keep any drainage sites clean at all times. Eat well. Get plenty of rest and sleep. Get help with your care, if needed. […] Good self-care is important for the healing process.

• #1 Osteomyelitis: Symptoms, Causes, and Treatment

  https://patient.info/bones-joints-muscles/osteomyelitis-leaflet

  Osteomyelitis may be prevented by: […] Keeping any cuts and skin wounds clean and dry. […] Dressing of wounds to avoid infection. […] Seeking medical attention for deep or open wounds – as specific cleaning techniques, dressings or antibiotics may be required, depending on the nature of the wound. […] Avoidance of high alcohol intake. […] Stopping smoking.

• #1 Osteomyelitis – North Memorial Health

  https://northmemorial.com/condition/osteomyelitis/

  To reduce your risk of osteomyelitis: […] Seek immediate medical care for infections or injuries. […] Keep diabetes under control. […] Do not use illegal drugs. […] See your healthcare provider for any sores that do not heal. […] If you smoke, talk to your healthcare provider about how you can successfully quit.

• #1 Bone Infection (Osteomyelitis): Symptoms and Treatments

  https://www.healthline.com/health/osteomyelitis

  Can you prevent osteomyelitis? Thoroughly wash and clean any cuts or open wounds in the skin. If a wound/cut does not look like it is healing with home treatment, contact your doctor immediately to have it examined. Clean and dry amputation sites before placing your prosthesis. Also, use the proper footwear and protective equipment to avoid injuries when jumping, running, or participating in sports.

• #1 Evolving concepts in bone infection: redefining “biofilm”, “acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy” | Bone Research

  https://www.nature.com/articles/s41413-019-0061-z

  Osteomyelitis is a devastating disease caused by microbial infection of bone. While the frequency of infection following elective orthopedic surgery is low, rates of reinfection are disturbingly high. Given the high patient morbidity, mortality, and economic burden caused by osteomyelitis, it is important to elucidate mechanisms of bone infection to inform novel strategies for prevention and curative treatment. […] While advances in prophylaxis and aseptic surgical technique have decreased the incidence of orthopedic infection following hip or knee arthroplasty, rigorous intervention studies have demonstrated that infection rates for elective surgery cannot be reduced below 1%2%. Additionally, rates of recurrent or persistent infection following a two-stage revision surgery are still as high as 33%.

• #1 Diagnosis and Management of Osteomyelitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1101/p1027.html

  The increased incidence of methicillin-resistant Staphylococcus aureus osteomyelitis complicates antibiotic selection. […] The recurrence rate remains high despite surgical intervention and long-term antibiotic therapy. […] In both situations, however, empiric antibiotic coverage for S. aureus is indicated. […] The preferred diagnostic criterion for osteomyelitis is a positive bacterial culture from bone biopsy in the setting of bone necrosis. […] Parenteral followed by oral antibiotic therapy is as effective as long-term parenteral therapy for the treatment of chronic osteomyelitis in adults. […] Antibiotic regimens for the empiric treatment of acute osteomyelitis, particularly in children, should include an agent directed against S. aureus. […] If methicillin resistance among community isolates of Staphylococcus is greater than 10 percent, MRSA should be considered in initial antibiotic coverage.

• #1

  https://journals.lww.com/otainternational/fulltext/2024/06001/prevention_and_treatment_of_osteomyelitis_after.6.aspx

  Infection risk is largely based on severity of open injury in addition to inherent patient factors. […] Orthopaedic surgeons can work to mitigate this risk with prompt antibiotic administration, thorough and complete debridement, expedient fracture stabilization, and early wound closure. […] A large focus of research over the past several decades related to treating open tibia fractures has been on the prevention of post-traumatic infection and osteomyelitis. […] One of the most important interventions to prevent infection for any open fracture is prompt antibiotic administration. […] Therefore, institutions are urged to promote antibiotic administration as soon as possible for open tibia fractures after injury. […] The aim of irrigation and debridement of an open tibia fracture is to prevent infection and promote healing.

• #1 Recommendations for the treatment of osteomyelitis | The Brazilian Journal of Infectious Diseases

  https://www.bjid.org.br/en-recommendations-for-treatment-osteomyelitis-articulo-S1413867014000579

  With the advances in surgical treatment, antibiotic therapy and the current resources for accurate diagnosis and differentiated approaches to each type of osteomyelitis, better results are being obtained in the treatment of this disease. […] The objective of this review article is to indicate some recommendations based on scientific evidence that will guide the medical approach to different types of osteomyelitis, aiming to obtain better clinical outcomes and at reducing the social costs of this disease. […] The success of osteomyelitis treatment, particularly in cases related to implants, is closely linked to extensive surgical debridement and adequate antibiotic therapy. […] Starting empirical antibiotics in anesthetic induction prevents the risks of bacteremia arising from surgical manipulation of infection without adequate antibiotic coverage.

• #1

  https://journals.lww.com/otainternational/fulltext/2024/06001/prevention_and_treatment_of_osteomyelitis_after.6.aspx

  The aim of irrigation and debridement of an open tibia fracture is to prevent infection and promote healing. […] Fracture stabilization is essential because aside from pain relief, it prevents further soft-tissue injury, restores soft-tissue tension, allows for decreased swelling, and improves circulation. […] The approach should be systematic and methodical, and the surgeons should be aware that fracture stabilization methods can affect ultimate wound management treatment plans. […] With a significant reported risk of up to 20% of open tibia fractures developing osteomyelitis, postoperative surveillance is vital. […] Ultimately, if osteomyelitis does develop, surgeons should have a systematic way to approach treatment.

• #1 PREVENTION AND TREATMENT OF OSTEOMYELITIS FOLLOWING OPEN FRACTURES BY USE OF A MEDICATED BONE GRAFT SUBSTITUTE IN A DEVELOPING COUNTRY SETTING | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/1358-992X.2019.4.057

  Prevention and treatment of postoperative osteomyelitis by introducing alcoholic hand-sanitizers and the use of wound debridement and implantation of a medicated bone graft substitute. […] By introducing better hand hygiene (by use of alcoholic hand sanitizers) and medicated bone graft substitutes, we hope to be able to prevent osteomyelitis after open fractures and also to treat chronic osteomyelitis cases.

• #1 Osteomyelitis Treatment & Management: Approach Considerations, Medical Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/1348767-treatment

  Prophylactic treatment with the bead pouch technique has been suggested in open fractures to reduce the risk of infection. Systemic antibiotics supplemented with antibiotic beads are preferred to systemic antibiotics alone. […] Antibiotic-impregnated ceramics can provide sustained therapeutic concentrations of antibiotics locally in treatment and prophylaxis of osteomyelitis and has been widely used in clinical practice for 40 years. […] The most commonly used commercially available antibiotic ceramic carriers are the following: Osteoset T – Hemihydrate calcium sulphate pellets, with tobramycin; Herafill G – Calcium sulphate and carbonate pellets, with gentamicin; Cerament G and Cerament V – Biphasic paste mix of calcium sulphate and nanocrystalline hydroxyapatite, with gentamicin (G) or vancomycin (V).

• #1 Treatment of chronic osteomyelitis with antibiotic-impregnated polymethyl methacrylate (PMMA) – the Cierny approach: is the second stage necessary? | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04979-y

  Chronic osteomyelitis is a challenge for orthopedic surgeons. Most patients with osteomyelitis receive two-stage management according to Cierny-Mader. The first stage includes radical debridement and insertion of an antibiotic-impregnated cement spacer (ACS) (beads, rods, nails, or blocks) into the bone defect. The second stage is performed 68 weeks later, when the spacer is removed and a cancellous autograft is placed within the bone defect. The possibility of ACS as definitive management for osteomyelitis, avoiding the second stage, is presented. […] Our study suggests that a proportion of patients with planned retention of ACS appear to function well without requiring further surgical intervention, especially in elderly or vulnerable patients. […] Our study on 16 patients proves the theory that the second stage of the Cierny-Mader approach to chronic osteomyelitis, in certain circumstances, can be avoided, and no complications are due to come out by retaining the ACA for long standing. […] According to our results, we believe that a second operation with all its risks can be avoided, especially in elderly or vulnerable host B or C patients.

• #1 Prophylaxis of Acute Osteomyelitis with Absorbable Ofloxacin-Impregnated Beads

  https://pmc.ncbi.nlm.nih.gov/articles/PMC105552/

  We investigated the use of an ofloxacin-impregnated bioabsorbable composite for the prevention of acute Staphylococcus aureus osteomyelitis. […] This study demonstrates the effectiveness of the implantable ofloxacin bioabsorbable composites to prevent the development of acute osteomyelitis. […] Therefore, the prevention of infection is one of the primary objectives in the orthopedic management of the patients at increased risk, such as those undergoing treatment of open fractures or total joint arthroplasty procedures. […] In addition, although the use of preventive antibiotics in patients undergoing prosthetic joint arthroplasty is still debated, it is now accepted practice. […] The purpose of this study was to investigate the effectiveness of an ofloxacin-impregnated bioabsorbable composite for the prevention of acute osteomyelitis after systemic bacterial inoculation.

• #1 Prophylaxis of Acute Osteomyelitis with Absorbable Ofloxacin-Impregnated Beads

  https://pmc.ncbi.nlm.nih.gov/articles/PMC105552/

  The observed prophylactic effects of the implantable ofloxacin-impregnated composites in our study are likely due to the early and sustained released of ofloxacin, which results in high local concentrations which reduce the number of viable bacteria to a level at which local defense mechanisms function adequately to eliminate bacteria. […] The radiographic, histologic, and culture data in this study demonstrate the effectiveness of implantable ofloxacin-bioabsorbable composites to prevent the development of acute osteomyelitis after systemic bacterial exposure.

• #1 How do I Manage a Patient with Osteomyelitis? | JCDA

  https://jcda.ca/g13

  Osteomyelitis is a common sequel of chronic periapical infection and may also be caused by pathologies that obstruct blood supply, causing ischemia. This leads to bone death and necrosis. […] Educate patients about good oral hygiene. […] Advise the patient to maintain local hygiene in areas of exposed bone (chlorhexidine gluconate 0.12%, 20 mL for 30 seconds 3 times daily).

• #1 CRISPR-Cas9 modified bacteriophage for treatment of Staphylococcus aureus induced osteomyelitis and soft tissue infection | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220421

  Osteomyelitis, or bone infection, is often induced by antibiotic resistant Staphylococcus aureus strains of bacteria. […] Difficulties in treating osteomyelitis, or the infection of bone, have been exacerbated by the rise of antibiotic resistant bacterial strains, particularly S. aureus strains, which are the most common cause of bone infection. […] It is essential that new therapeutics be engineered and tested, for rapid translation into clinical use. […] Bacteriophages (phages), or viruses that while in a lytic state kill their bacterial hosts, are one class of therapeutics that have gained attention in recent years due to their high specificity, non-toxicity, and abundancy in nature. […] Alginate hydrogels are injectable, well characterized, and biocompatible. […] In this study, we have avoided debridement altogether so as to limit potential clearing of infection from any source other than the therapeutics delivered.

• #1 Recommendations for the treatment of osteomyelitis | The Brazilian Journal of Infectious Diseases

  https://www.bjid.org.br/en-recommendations-for-treatment-osteomyelitis-articulo-S1413867014000579

  The duration of antibiotic therapy varies from four weeks to six months, and the treatment should be adjusted based on the results of the cultures collected, where necessary. […] Chronic infections should be treated with extensive surgical debridement and removal of any synthesis materials, which can be replaced during the same surgical procedure if there is orthopedic indication. […] Hyperbaric oxygen therapy (HBO) is a form of adjuvant therapy that has been used worldwide for more than sixty years. […] The use of hyperbaric oxygen (O2HB) is associated with all the other therapeutic measures, making them more effective.

• #1 Evolving concepts in bone infection: redefining “biofilm”, “acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy” | Bone Research

  https://www.nature.com/articles/s41413-019-0061-z

  Despite infection treatment strategies such as surgical site debridement, complete hardware exchange, and aggressive long-term antimicrobial therapy, infections continue to recur. […] These data are consistent with the conclusions from the 2018 International Consensus Meeting on Musculoskeletal Infection, which found that the incidences of infection for all orthopedic subspecialties range from 0.1% to 30%, at a cost of $17 000$150 000 per patient. […] For these reasons, S. aureus will be the primary focus of this review. […] As a result of these highly evolved pathogenic mechanisms of persistence, clinical S. aureus osteomyelitis recurrence after decades of quiescence remains an important problem. […] Thus, the goal of this review is to highlight these potential breakthroughs, which challenge the scientific premise of established paradigms, including acute and chronic osteomyelitis, intracellular infection of bone cells, and the efficacy of antibiotic-laden bone cement.

• #1 Diagnosis and Management of Osteomyelitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/1101/p1027.html

  Despite the use of surgical debridement and long-term antibiotic therapy, the recurrence rate of chronic osteomyelitis in adults is about 30 percent at 12 months. […] For chronic osteomyelitis, parenteral antibiotic therapy for two to six weeks is generally recommended, with a transition to oral antibiotics for a total treatment period of four to eight weeks.

• #2 OSTEOMYELITIS – Orthopaedic Surgeon Australia – Minimally Invasive Procedures

  https://orthopaedic-surgeon.com.au/osteomyelitis/

  Cleanliness is the key to the prevention of osteomyelitis. At best, ensure that you are washing wounds that are visible. Cover the wounds, and keep bandaged where possible. […] Osteomyelitis, like all conditions, is better prevented than treated. It is a preventable condition, however there are special circumstances that can result in its development. Seeking appropriate medical care will take you on the road to recovery.

• #2 Osteomyelitis (Bone Infection): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/osteomyelitis-bone-infection

  Cleaning new wounds or cuts and keeping surgery sites sterile are the best ways to prevent bone infections. Wash your hands frequently, and clean scrapes and cuts with warm, soapy water. Go to the emergency room if you have a deep cut or puncture (stab) wound or experience trauma. […] Taking the full dose of any medication your healthcare provider prescribes to kill the initial infection is the best way to prevent chronic osteomyelitis.

• #2 Osteomyelitis (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/osteomyelitis.html

  One way to prevent osteomyelitis is to keep skin clean. All cuts and wounds especially deep wounds should be cleaned well. Wash a wound with soap and water, holding it under running water for at least 5 minutes to flush it out. […] To keep the wound clean afterward, cover it with sterile gauze or a clean cloth. You can apply an over-the-counter antibiotic cream, but the most important thing is to keep the area clean. Wounds should begin healing within 24 hours and completely heal within a week. A wound that takes longer to heal or causes extreme pain should be checked by a doctor. […] Parents and kids should wash their hands well and often to stop the spread of germs. Kids also should have their vaccinations kept up to date.

• #2 Osteomyelitis – North Memorial Health

  https://northmemorial.com/condition/osteomyelitis/

  To reduce your risk of osteomyelitis: […] Seek immediate medical care for infections or injuries. […] Keep diabetes under control. […] Do not use illegal drugs. […] See your healthcare provider for any sores that do not heal. […] If you smoke, talk to your healthcare provider about how you can successfully quit.

• #2 Osteomyelitis: Symptoms, causes, complications, and treatment

  https://www.medicalnewstoday.com/articles/178819

  To prevent osteomyelitis, doctors recommend: […] for people with diabetes, having prompt medical care for any issues involving the feet […] for people with peripheral neuropathy, always wearing shoes, to prevent wounds.

• #2 Osteomyelitis (Bone Infection): Symptoms, Causes & Treatment

  https://www.metropolisindia.com/blog/preventive-healthcare/understanding-osteomyelitis-bone-infection-symptoms-causes-and-treatment

  How can you prevent osteomyelitis? […] Preventive Measures: […] Avoiding Injected Illegal Drugs: Refrain from engaging in the use of injected illegal substances to reduce the risk of osteomyelitis. […] Prompt Medical Care for Diabetes: If you have diabetes, ensure timely medical attention for any foot-related issues to minimise the likelihood of osteomyelitis. […] Wearing Shoes for Peripheral Neuropathy: If you experience peripheral neuropathy, always wear shoes to prevent wounds, a crucial step in osteomyelitis prevention.

• #2 Prophylaxis of Acute Osteomyelitis with Absorbable Ofloxacin-Impregnated Beads

  https://pmc.ncbi.nlm.nih.gov/articles/PMC105552/

  We investigated the use of an ofloxacin-impregnated bioabsorbable composite for the prevention of acute Staphylococcus aureus osteomyelitis. […] This study demonstrates the effectiveness of the implantable ofloxacin bioabsorbable composites to prevent the development of acute osteomyelitis. […] Therefore, the prevention of infection is one of the primary objectives in the orthopedic management of the patients at increased risk, such as those undergoing treatment of open fractures or total joint arthroplasty procedures. […] In addition, although the use of preventive antibiotics in patients undergoing prosthetic joint arthroplasty is still debated, it is now accepted practice. […] The purpose of this study was to investigate the effectiveness of an ofloxacin-impregnated bioabsorbable composite for the prevention of acute osteomyelitis after systemic bacterial inoculation.

• #2 Prophylaxis of Acute Osteomyelitis with Absorbable Ofloxacin-Impregnated Beads

  https://pmc.ncbi.nlm.nih.gov/articles/PMC105552/

  The observed prophylactic effects of the implantable ofloxacin-impregnated composites in our study are likely due to the early and sustained released of ofloxacin, which results in high local concentrations which reduce the number of viable bacteria to a level at which local defense mechanisms function adequately to eliminate bacteria. […] The radiographic, histologic, and culture data in this study demonstrate the effectiveness of implantable ofloxacin-bioabsorbable composites to prevent the development of acute osteomyelitis after systemic bacterial exposure.

• #2 CRISPR-Cas9 modified bacteriophage for treatment of Staphylococcus aureus induced osteomyelitis and soft tissue infection | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220421

  In future studies, debridement may be included to more readily mimic the clinical scenario and enable evaluation of larger antibacterial materials such as scaffolds or putties. […] Although only the fosfomycin group resulted in reduced bacterial load in the femur, in soft tissue, all three treatments, including phage alone and phage with fosfomycin (dual) led to lower bacterial counts compared to empty alginate. […] To improve bacteriological outcomes in the future, further investigations of delivery vehicles and optimal dosing are warranted.

• #2 Evolving concepts in bone infection: redefining “biofilm”, “acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy” | Bone Research

  https://www.nature.com/articles/s41413-019-0061-z

  Despite infection treatment strategies such as surgical site debridement, complete hardware exchange, and aggressive long-term antimicrobial therapy, infections continue to recur. […] These data are consistent with the conclusions from the 2018 International Consensus Meeting on Musculoskeletal Infection, which found that the incidences of infection for all orthopedic subspecialties range from 0.1% to 30%, at a cost of $17 000$150 000 per patient. […] For these reasons, S. aureus will be the primary focus of this review. […] As a result of these highly evolved pathogenic mechanisms of persistence, clinical S. aureus osteomyelitis recurrence after decades of quiescence remains an important problem. […] Thus, the goal of this review is to highlight these potential breakthroughs, which challenge the scientific premise of established paradigms, including acute and chronic osteomyelitis, intracellular infection of bone cells, and the efficacy of antibiotic-laden bone cement.

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