Recommendations for the treatment of osteomyelitis

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. After a careful literature review carried out by a multiprofessional team, some conclusions were made in order to guide medical approach to different types of osteomyelitis, aiming to obtain better clinical outcomes and reducing the social costs of this disease. Acute and chronic osteomyelitis are discussed, with presentation of the general epidemiological concepts and the commonly used classification systems. The main guidelines for the clinical, laboratory and imaging diagnosis of infections are discussed, as well as the guidelines for surgical and antimicrobial treatments, and the role of hyperbaric oxygen as adjuvant therapy.

Aspectos atuais do diagnóstico e tratamento das osteomielites / Current aspects of diagnosis and treatment of osteomyelitis

As infecçöes osteoarticulares, com relativa freqüência, säo difíceis de diagnosticar, necessitam de tratamentos prolongados, que podem ser ineficazes, levando à incapacidade definitiva do membro. As osteomielites agudas, que na maioria das vezes se apresentam em crianças, säo uma doença menos complexa, de tratamento mais fácil e, se conduzido adequadamente, näo leva a seqüelas. Já as osteomielites crônicas, geralmente de diagnóstico e tratamento tardios, têm uma série de variáveis que dificultam o sucesso terapêutico. Para tentar melhorar o entendimento da fisiopatologia, diagnóstico e tratamento dessas entidades, realizamos esta revisäo anexando dados de experiência do serviço onde atuamos.