Spectrum: Local Antimicrobial Stewardship, for Eastern Health

Osteomyelitis Duration of Therapy

Recommended Duration

6 weeks

Osteomyelitis Treatment Guidelines

Shortest Duration

6 weeks

Additional Notes

  • The data regarding limiting duration to 6 weeks comes from several well done RCTs on disparate patient populations including:

    • Vertebral osteomyelitis
    • Diabetic foot infections
    • Prosthetic join infections with retained hardware

  • The similarity of the data in all these patient populations suggests that it is likely that 6 weeks is more than adequate

  • A cohort study suggested that even shorter durations may have equivalent outcomes, however this needs further support from adequately powered RCTs

  • Adapted from AMMI Canada Position Statement on the Appropriate Duration of Antimicrobial Therapy (2018)

More Information

References
  1. Chaussade H, Uçkay I, Vuagnat A et al., Antibiotic therapy duration for prosthetic joint infections treated by Debridement and Implant Retention (DAIR): Similar long-termremission for 6 weeks as compared to 12 weeks, International Journal of Infectious Diseases. 63(2017):37-42, 2017
  2. Tone A, Nguyen S, Devemy F et al., Six-Week Versus Twelve-Week Antibiotic Therapy for Nonsurgically Treated Diabetic Foot Osteomyelitis: A Multicenter Open-Label Controlled Randomized Study. Diabetes Care, 38 (Feb):302-7. 2015
  3. Locke T, Kell M, Bhattacharyya D et al., Spontaneous methicillin-sensitive Staphylococcus aureus spondylodiscitis - Short course antibiotic therapy may be adequate: Evidence from a single centre cohort. Journal of Infection and Public Health 7:44—49. 2014