Osteomyelitis is the infection of bone characterized by high grade fever, pain, localised swelling and inability to move the affected bone/joint. In severe cases it may lead to loss of limb and sepsis. Acute osteomyelitis usually needs intravenous antibiotic therapy.
Medications:
- Inj. Lizoforce (Linezolid 600 mg) i.v. 12 hourly AND
- Inj. Biotax (Cefotaxime 1 gm) i.v. 12 hourly.
Continue these antibiotics till bone biopsy, blood and superficial wound culture and antibiotic sensitivity report suggests otherwise.
Oral treatment following i.v. course:
- Tab. Lizoforce 600 (Linezolid 600 mg) 1 tablet twice a day AND
- Tab. Doxcef 200 (Cefpodoxime 200 mg) 1 tablet twice a day
- Prolonged oral antibiotics are needed in chronic osteomyelitis.
Supportive treatments:
- Tab. Dolo 650 (Paracetamol 650 mg) 1 tablet 4 times a day till symptoms improve.
- Tab. Limcee (Vitamin C 500 mg) 1 tablet once a day along with Dolo 650.
- Tab. Chymoral forte (Trypsin, Chymotrypsin 1 lac AU) 1 tablet 2-3 times a day with food (to reduce swelling and pain).
General advice:
- Splint the affected part till infection settles.
- Ensure adequate hydration.
- Apply antiseptic dressings if there is any evidence of skin breakage.
- Prevent secondary infections
- Ensure regular follow up and frequent dressing changes.
Investigations:
- CBC – raised white cell count and CRP is suggestive of infection and used to assess response to treatment.
- X ray of the affected part – to look for elevated periosteum.
- MRI of the affected area – to confirm the diagnosis and rule out other differential diagnosis.
- Blood culture or culture of the pus from the site – to study microbiology and antibiotic sensitivity.
Referral:
Consider referring patients to orthopaedic surgeon in case of failure to respond or if patients present with additional complications.