Acute osteomyelitis in a district general hospital.

A survey of the 58 patients with acute osteomyelitis seen in one general hospital between 1969 and 1979 has shown that, although the condition is less common now than in the pre-antibiotic era, it remains a serious disease. Bone pain and tenderness are still the commonest symptoms, but the source of the infection is less apparent now than it used to be, and this may lead to delay in diagnosis. The antecedent trauma experienced by nearly half the patients probably predisposes to infection by causing local bone damage and thus a focus for secondary infection. The pattern of infecting organisms has not changed much over the past 11 years, but Haemophilus influenzae must be considered in children aged under 5 years. Treatment was the use of antibiotics, with surgical drainage if necessary. The commonest antibiotic used was clindamycin, and chronic osteomyelitis did not develop in patients treated with this antibiotic, whereas all 9 patients who had chronic sequelae necessitating sequestrectomy had received cloxacillin either alone or in combination with another antibiotic.