Osteomyelitis

Abstract

In the diabetic foot osteomyelitis most often develops through contiguous spread of bacteria from an open wound or ulceration. These infections may be monomicrobial or polymicrobial, and frequently involve high burdens of organisms and biofilm formation, rendering treatment complex. Diagnostic imaging combined with clinical parameters and laboratory testing are used in establishing the diagnosis. In many cases a combination of surgical intervention and antibiotic therapy, often prolonged, is needed to prevent recurrence. An understanding of the microbiology, including the most commonly implicated organisms in these infections, can help guide empiric antibiotic therapy. When microbiology data is available, this information should be incorporated into decision making for definitive antibiotic management. In many cases antibiotic therapy is administered parenterally but oral antibiotics with high bioavailability and bone penetration may be acceptable in specific situations.