Use of antibiotic beads in treating chronic osteomyelitis

Abstract

Background and Objectives: Chronic osteomyelitis results when bone tissue dies as a result of the lost blood supply. Usual management includes sequestrectomy and administration of high doses of antibiotics, but this can be difficult because of the limited circulation and poor penetration of antimicrobial agents into the site. Inherent undesirable side effects may also render systemic antibiotic treatment inadvisable. Osteomyelitis of the maxillofacial skeleton may not be very common in the developed countries but incidences are high in developing countries. But regardless of the country of origin, there is a select groups of patients who have an increased risk of developing osteomyelitis: specifically those who have undergone radiotherapy affecting the mandible (which may result in a specific form of osteomyelitis termed osteoradionecrosis), and the immunocompromised, including uncontrolled diabetics, and patients on immunosuppressive therapy, making systemic treatment of high dose antibiotics more complicated. In developing countries, chronic osteomyelitis often results from untreated acute haematogenous osteomyelitis. This study aims to present a good alternative for difficult chronic and refractory cases in the form of polymethyl methacrylate beads impregnated with antibiotics.