Oral antibiotics vs Intravenous antibiotics in treatment of
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The study published in the Journal of Oral & Maxillofacial Surgery states that oral antibiotics and surgery are an effective treatment option for osteomyelitis of the jaw (OMJ).

The purpose of this study was to review treatment of osteomyelitis of the jaw (OMJ) and determine whether antibiotic route and/or length of administration impact resolution of infection post-surgically.

The investigators designed a retrospective cohort study enrolling a sample of patients treated at Harborview Medical Center. The primary predictor variable was antibiotic administration route: oral (PO) only, intravenous (IV) only, IV transitioned to PO (IV+PO), or none. The secondary predictor was the duration of antibiotic therapy (?6 weeks or >6 weeks). The primary outcome variable was a resolution of infection at 2-month follow-up post-treatment completion. The secondary outcome variable was the number of surgeries to the resolution of infection.

67 subjects met inclusion criteria, mean age 51 years.

--Forty-nine received PO antibiotics, 12 IV+PO, 3 IV, and 3 none. Both PO and IV antibiotics were associated with clinical resolution compared to debridement alone.

--Antibiotic duration of ?6 weeks compared to >6 weeks was not significant. 76% required only 1 surgery.

--In the multivariate logistic regression, PO was associated with clinical resolution.

--Penicillin allergy and diabetes were adversely associated with outcome.

In conclusion, OMJ was successfully treated with oral antibiotics and surgery. Prescribing 6 weeks of IV antibiotics may be antiquated. Clinicians should consider oral penicillins as the first-line whenever possible.

Source: https://doi.org/10.1016/j.joms.2021.04.020
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