title: Duration of post-surgical antibiotic therapy for adult chronic osteomyelitis: a single-centre experience.
abstract: OBJECTIVE
  The optimal duration of concomitant antibiotic therapy after surgical intervention for implant-free chronic osteomyelitis is unknown. No randomized data exist. Available recommendations are based on expert's opinion. We evaluated the duration of post-surgical antibiotic treatment related to remission of chronic osteomyelitis.
  
  
  METHODS
  This was a retrospective single-centre study at Geneva University Hospitals with a minimal follow-up of two years after treatment. We used multivariate logistic regression analysis with exclusion of pediatric cases and of implant-related chronic osteomyelitis.
  
  
  RESULTS
  A total of 49 episodes of implant-free chronic osteomyelitis in 49 adult patients were studied. The median number of surgical interventions was two (range, 1-10). The median duration of post-debridement antibiotic treatment was eight weeks (range, 4-14 weeks). Thirty-nine patients (80%) were in remission after a minimal follow-up of two years. In multivariate logistic regression analysis, one week of intravenous therapy had the same remission as two to three weeks (0.2, 0.1-1.9) or ≥ 3 weeks (0.3, 0.1-2.4). More than six weeks of total antibiotic treatment equalled ≤  six weeks (0.8, 0.1-5.2).
  
  
  CONCLUSIONS
  In chronic osteomyelitis in adults, a post-debridement antibiotic therapy beyond six weeks, or an IV treatment longer than one week, did not show enhanced remission incidences. Prospective randomized trials are required to confirm this observation.
authors.affiliation: Department of Orthopedic Surgery, Geneva University Hospitals & Faculty of Medicine, University of Geneva, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.
authors.forename: Thierry
authors.initials: T
authors.lastname: Rod-Fleury
authors.forename: Nathalie
authors.initials: N
authors.lastname: Dunkel
authors.forename: Mathieu
authors.initials: M
authors.lastname: Assal
authors.forename: Peter
authors.initials: P
authors.lastname: Rohner
authors.forename: Phedon
authors.initials: P
authors.lastname: Tahintzi
authors.forename: Louis
authors.initials: L
authors.lastname: Bernard
authors.forename: Pierre
authors.initials: P
authors.lastname: Hoffmeyer
authors.forename: Daniel
authors.initials: D
authors.lastname: Lew
authors.forename: Ilker
authors.initials: I
authors.lastname: Uçkay
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D012074:Remission Induction; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents