Address for Correspondence/Yazışma Adresi: İlker Uçkay MD,
Geneva University Medical Research Center, Clinic of Pathology and Immunology, Geneva, Switzerland
Phone: +41-22-272-33118 E-mail: ilker.uckay@hcuge.ch ORCID ID: orcid.org/0000-0002-5552-0973
Received/Geliş Tarihi: 31.07.2017 Accepted/Kabul Tarihi: 02.12.2017
©Copyright 2017 by the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey
Mediterranean Journal of Infection, Microbes and Antimicrobials published by Galenos Yayınevi.
DOI: 10.4274/mjima.2017.15
Mediterr J Infect Microb Antimicrob 2017;6:15
Erişim: http://dx.doi.org/10.4274/mjima.2017.15
Cite this article as: Hirsiger S, Ilgaz İ, Uçkay İ. New Antibiotics in the Therapy of Osteomyelitis. Mediterr J Infect Microb Antimicrob. 2017;6:15.
REVIEW / DERLEME
Osteomyelitis is probably the oldest known infection in the history of life. It can develop secondary to local tissue disruption, ischemia and associated
chronic wounds or via hematogenous infection. Although it has been known to the medical community for a long time, treatment remains
challenging. Detection of the microbial agent remains crucial for the associated antibiotic therapy. Also, tissue specimens for culture and histology
must be obtained. Several factors such as biofilm formation, resistance development and special virulence factors can impede the efficiency of the
antibiotic treatment. In the last two decades, developments of antibiotic agents with available data in the field of osteomyelitis primarily include
brilacidin, ceftaroline, ceftobiprole, dalbavancin, daptomycin, tedizolid, telavancin, tigecycline. Many of them are not on the market, or under study,
or only found in selected countries. However, they are expected to become more accessible in coming years.
Keywords: Osteomyelitis, antibiotic therapy, new developments, hyperbaric oxygen, nemanoxacin
Osteomiyelit büyük bir olasılıkla yaşam tarihindeki en eski tanımlanmış enfeksiyondur. Lokal doku zedelenmesine ikincil olarak, iskemi ve iskemiyle
bağlantılı kronik yaralarla ya da kanda oluşan bir enfeksiyon yoluyla gelişebilir. Tıp dünyası tarafından uzun süredir bilinmesine rağmen, tedavisi
zorlayıcıdır. İlgili antibiyotik tedavisi için mikrobiyal ajanın saptanması çok önemlidir. Bunun yanında, kültür ve histoloji için doku örnekleri de elde
edilmelidir. Antibiyotik tedavisinin etkisini; biyofilm oluşumu, antibiyotiğe karşı direnç gelişimi veya spesifik virülans faktörleri zorlaştırabilmektedir.
Son 20 yılda, osteomiyelit alanında geliştirilen başlıca antibiyotikler arasında brilasidin, seftarolin, seftobiprol, dalbavansin, daptomisin, tedizolid,
telavansin ve tigesiklin sayılabilir. Geliştirilen pek çok antibiyotik ya henüz pazara sunulmamış, ya hala çalışmaları devam etmekte ya da sadece belli
ülkelerde bulunmaktadır. Ancak önümüzdeki yıllarda bu antibiyotiklerin daha erişilebilir olması beklenmektedir.
Anahtar Kelimeler: Osteomiyelit, antibiyotik tedavisi, yenilikler, hiperbarik oksijen, nemanoxacin
New Antibiotics in the Therapy of Osteomyelitis
Osteomiyelit Tedavisinde Yeni Antibiyotikler
Abstract
Öz
Stefanie HIRSIGER
1
, İlke ILGAZ
2
, İlker UÇKAY
1,3
1
Geneva University Hospitals, Orthopedic Surgery Service, Geneva, Switzerland
2
Geneva University Medical Research Center, Clinic of Pathology and Immunology, Geneva, Switzerland
3
Geneva University Hospitals, Service of Infectious Diseases, Geneva, Switzerland
Published: 4 December 2017
Introduction
Osteomyelitis is a disease that has been known for centuries
and has been detected in fossils that deceased 275 million
years ago
[1]
, due to possibly the same pathogens as today.
Nevertheless, its treatment is still under ongoing discussion.
Almost four years ago, we published a review in this journal
regarding the pharmaceutic properties of antimicrobial agents
for chronic implant-free osteomyelitis in adults
[2]
. Today, we
give new insights into the developments of osteomyelitis of
the last two decades with an emphasis on recent years. Of
note, this review excludes diabetic foot osteomyelitis, which
is an epiphenomena of a more important underlying chronic
disease
[3]
, such as arterial insufficiency, patient’s compliance,
polyneuropathy, and polyneuropathic anatomical alterations.
Thus, the treatment of diabetic foot osteomyelitis emphasizes
the corrections of underlying problems and would be beyond
the scope of this review. Likewise, our short review excludes
pediatric osteomyelitis, preventive aspects of nosocomial