Antibiotics for treating chronic osteomyelitis in adults
Information
- DOI:
- https://doi.org/10.1002/14651858.CD004439.pub3Copy DOI
- Database:
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- Cochrane Database of Systematic Reviews
- Version published:
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- 06 September 2013see what's new
- Type:
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- Intervention
- Stage:
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- Review
- Cochrane Editorial Group:
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Cochrane Bone, Joint and Muscle Trauma Group
- Copyright:
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- Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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Cited by:
Authors
Contributions of authors
Prof Lucieni Oliveira Conterno screened studies for inclusion, performed data extraction and analyses, interpreted results and wrote the review. Prof Conterno is the guarantor of the review.
Prof Marilia Dalva Turchi screened studies for inclusion, performed data extraction and analyses, interpreted results and wrote the review update.
Sources of support
Internal sources
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Marilia Medical School, Brazil.
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Institute of Tropical Pathology and Public Health, Federal University of Goias, Brazil.
External sources
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MDT has a scholarship from the Brazilian National Research Council (Bolsa de Produtividade CNPq), Brazil.
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MDT is a research member of the National Institute of Science and Technology for Health Technology Assessment (IATS), Brazil.
Declarations of interest
Lucieni O Conterno ‐ none known
Marilia D Turchi ‐ none known
Acknowledgements
We are grateful to Prof Carlos Rodrigues da Silva Filho for his contribution to the first version of the review.
We are very grateful to Dr Karla Soares Weiser for her suggestions on the protocol and the Iberoamerican Cochrane Centre for assistance during the review. We are very grateful to Lesley Gillespie for searching for the studies and help during the editorial process, Joanne Elliott for updating the search, and Lindsey Elstub, Helen Handoll, Lesley Gillespie, Vicki Livingstone, Janet Wale and Geert Walenkamp for valuable comments and guidance during this review.
Version history
| Published | Title | Stage | Authors | Version |
| 2013 Sep 06 | Antibiotics for treating chronic osteomyelitis in adults | Review | Lucieni O Conterno, Marilia D Turchi | |
| 2009 Jul 08 | Antibiotics for treating chronic osteomyelitis in adults | Review | Lucieni O Conterno, Carlos Rodrigues da Silva Filho | |
| 2003 Oct 20 | Antibiotics for treating chronic osteomyelitis in adults | Protocol | Lucieni O Conterno, Carlos Rodrigues da Silva Filho | |
Differences between protocol and review
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In line with Collaboration recommendations, we assessed the risk of bias in included studies.
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We have made several amendments to the types of outcome measures since the protocol was published.
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We clarified that treatment failure also includes early termination of treatment, such as for adverse effects or disease complications such as amputation.
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We added superinfection as a secondary outcome.
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We removed squamous cell carcinoma as a potential adverse event of treatment.
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We deleted length of hospital stay and cost from 'Adverse events' and placed them under 'Resource use'.
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Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Adult; Humans;
PICOs
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
Comparison 1 Oral antibiotic versus parenteral antibiotic (AB), Outcome 1 Remission at the end of treatment.
Comparison 1 Oral antibiotic versus parenteral antibiotic (AB), Outcome 2 Remission at least 12 months after the end of treatment.
Comparison 1 Oral antibiotic versus parenteral antibiotic (AB), Outcome 3 Mild adverse events.
Comparison 1 Oral antibiotic versus parenteral antibiotic (AB), Outcome 4 Moderate or severe adverse events.
Comparison 1 Oral antibiotic versus parenteral antibiotic (AB), Outcome 5 Superinfection.
Comparison 2 Oral antibiotic versus parenteral plus oral antibiotic, Outcome 1 Remission at least 12 months after the end of the treatment.
Comparison 2 Oral antibiotic versus parenteral plus oral antibiotic, Outcome 2 Adverse events.
Comparison 3 Parenteral plus oral antibiotics versus parenteral antibiotic, Outcome 1 Remission at least 12 months after the end of treatment.
Comparison 3 Parenteral plus oral antibiotics versus parenteral antibiotic, Outcome 2 Adverse events.
Comparison 4 Parenteral antibiotic 1 (ceftazidime) versus parenteral antibiotic 2 (ticarcillin plus tobramycin), Outcome 1 Remission at least 12 months after the end of the treatment.
Comparison 4 Parenteral antibiotic 1 (ceftazidime) versus parenteral antibiotic 2 (ticarcillin plus tobramycin), Outcome 2 Adverse events.
Comparison 4 Parenteral antibiotic 1 (ceftazidime) versus parenteral antibiotic 2 (ticarcillin plus tobramycin), Outcome 3 Superinfection.
Comparison 5 Oral antibiotic 1 (ciprofloxacin) versus oral antibiotic 2 (lomefloxacin), Outcome 1 Remission at least 12 months after the end of treatment.
Comparison 5 Oral antibiotic 1 (ciprofloxacin) versus oral antibiotic 2 (lomefloxacin), Outcome 2 Adverse events.
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Remission at the end of treatment Show forest plot | 4 | 150 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.04 [0.92, 1.18] |
| 2 Remission at least 12 months after the end of treatment Show forest plot | 3 | 118 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.94 [0.78, 1.13] |
| 3 Mild adverse events Show forest plot | 3 | 118 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.08 [0.49, 2.42] |
| 4 Moderate or severe adverse events Show forest plot | 3 | 91 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.69 [0.19, 2.57] |
| 5 Superinfection Show forest plot | 3 | 124 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.08 [0.33, 3.60] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Remission at least 12 months after the end of the treatment Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 2 Adverse events Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Remission at least 12 months after the end of treatment Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 2 Adverse events Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Remission at least 12 months after the end of the treatment Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 2 Adverse events Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 3 Superinfection Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1 Remission at least 12 months after the end of treatment Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
| 2 Adverse events Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Totals not selected | |
