Don't Treat Ghosts Anti-MRSA Antibiotics in Osteomyelitis Without Identified MRSA

Methodist Health System

Status: Enrolling

Conditions: Osteomyelitis

Treatments: Drug: Anti-MRSA therapy

Study type: Observational

Funder types: Other

Identifiers

NCT06096012

025.PHA.2023.A

Details and patient eligibility

About

Osteomyelitis is described as infection and inflammation of the long bone or bone marrow, often due to an open wound, operation, or invasive trauma.1 It is invasive and involves hematogenous seeding or contiguous spread of the infectious organism

Full description

This disease can be classified by location of infection, extent of spread, chronicity, and source of infection.3,4 Osteomyelitis can be caused by a variety of organisms, most commonly gram-positive staphylococci.

Osteomyelitis is associated with a high rate of relapse, high disease burden, and high health care costs.3 Following confirmation of disease via imaging and histopathologic examination, treatment consists of antibiotic therapy and, often, surgical intervention.3,5,6 Treatment with antibiotic therapy is often administered for 4-6 weeks when surgical intervention is not performed.6 Antibiotic selection should be guided by microbiology and antimicrobial susceptibilities.4 Thirty to sixty percent of osteomyelitis cases are caused by Staphylococcus aureus.

Enrollment: 365 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• • Admission to any MHS hospital between April 1, 2017 and April 1, 2023

  • > 18 years of age
  • Documented osteomyelitis location of the lower limb via ICD-10 code
  • Documented imaging of lower limb osteomyelitis during index admission
  • Planned intravenous (IV) antibiotics for at least 4 weeks

Exclusion criteria

• • IV antibiotics for less than 24 hours inpatient

  • Planned surgical intervention documented at admission
  • Patients receiving monotherapy with an anti-MRSA agent
  • Positive MRSA culture during index admission
  • Current outpatient antibiotic use on index admission
  • Repeated hospital admission during study period