Combined treatment with antibiotic, heparin and streptokinase--a new approach to the therapy of bacterial osteomyelitis.
Combined treatment by continuous intravenous infusion of a selected antibiotic and heparin and/or streptokinase was elaborated as a method of causal, systemic treatment of bacterial osteomyelitis. The aim of the combined treatment was to overcome infection and disturbances in the coagulation and fibrinolysis system which lead to impairment of the bone blood supply and its subsequent necrosis as the main factor in the aetiopathology of osteomyelitis. Between 1969 and 1991, combined treatment was introduced in 63 patients with acute onset disease or with chronic osteomyelitis. Osteomyelitis was located in the mandible in 38 patients and in the long bones in 14 patients. Prior to combined treatment, moderate bone surgery was performed in 21 patients, while 31 patients were excluded from surgery. Combined treatment with an antibiotic and heparin (A+H) was performed in 43 patients, and the other 6 patients had infusion of an antibiotic, streptokinase and heparin (A+S+H). The authors' method of combined treatment offers a new approach and an alternative to routinely-ordered antibiotic therapy and radical surgery, which allow frequent recurrences of the disease, a long-lasting course and severe complications.
Bartowski
S B
SB
Department of Maxillo-Facial and Oral Surgery, Jagiellonian University, Cracow, Poland.
Heczko
P B
PB
Lisiewicz
J
J
Dorozyński
J
J
Kurek
M
M
Kuśmiderski
J
J
Kasprzyk
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000667:Ampicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000601:surgery; D003131:Combined Modality Therapy; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008034:Lincomycin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008336:Mandibular Diseases / Q000188:drug therapy* / Q000382:microbiology* / Q000601:surgery; D008712:Methicillin / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology* / Q000601:surgery; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D005839:Gentamicins; D010406:Penicillins; D000667:Ampicillin; D006493:Heparin; D008034:Lincomycin; D013300:Streptokinase; D008712:Methicillin