Oral and parenteral amoxycillin/clavulanic acid in conjunction with surgery for the management of chronic osteomyelitis and severe bone infection

Forty-four patients with chronic osteomyelitis and severe bone infection received parenteral and oral amoxicillin/clavulanic acid (Augmentin®) in conjunction with sequestrectomy or drainage. Staphylococci were the main pathogens identified, although Escherichia coli, streptococci, and Proteus species were also isolated. Parenteral Augmentin was administered before, during, or after surgery for a mean of 5.8 days, followed by oral Augmentin for a mean of 5.6 weeks. At the end of the oral treatment, cure or improvement was noted in all patients, with absence of fistulae, and abscesses and good or satisfactory joint mobility seen in more than 80% of the patients. Follow-up assessments at a mean of 8 months posttreatment noted clinical cure in 82.9% of patients, with bacteriologic cure recorded in 94.4%. Adverse reactions were seen in seven patients.