Management: Non-Surgical
- If sepsis suspected: Sepsis 6
- To treat the osteomyelitis, treat the lesion overlying it
- Low MRSA prevalence and pt unwell: Flucloxacillin IV within 1 hour of admission
- High MRSA Prevalence and pt unwell: Vancomycin IV within 1 hour of arrival
If there are contraindications / patient doesn’t tolerate Vancomycin use Linezolid or Teicoplanin - Refer to your local formulary!!
Wound care:
Antibiotic Therapy:
The key management of chronic osteomyelitis is good wound care. Regular dressing changes, good input from podiatry and diabetic nurses / district nurses really is invaluable for your most at-risk patients.
Managing any ulcers or lesions that are overlying an area of suspected osteomyelitis is how you prevent acute flare ups and stop is from disseminating further into local tissues.
This is just a guide for the antibiotic therapy, in practice each board will have its own formulary so on NHS Grampian they have their own antibiotic policy whereas in Highland there is the TAM app which has their formulary on it.
