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This study describes the microbiological spectrum of chronic osteomyelitis and so guides the choice of empirical antibiotics for this condition.We performed a prospective review of a 166 prospective patient series of chronic osteomyelitis from Oxford, UK in which a standardised surgical sampling protocol was used.Staphylococcus aureus was most commonly isolated (32%) amongst a wide range of organisms including gram negative bacilli, anaerobes and coagulase negative staphylococci. Low grade pathogens were not confined to patients with a history of metalwork, a high proportion of cases were polymicrobial (29%) and culture negative cases were common (28%). No clear predictors of causative organism could be established. Many isolates were found to be resistant to commonly used empirical anti-microbial regimens.The wide range of causative organisms and degree of resistance to commonly used anti-microbials supports the importance of extensive intra-operative sampling and provides important information to guide clinicians' choice of empirical antibiotics.

Original publication




Journal article


The Journal of infection

Publication Date





338 - 343


Department of Microbiology & Infectious Diseases, Oxford Radcliffe Hospitals' Trust, Oxford, UK.


Humans, Bacteria, Bacterial Infections, Osteomyelitis, Chronic Disease, Anti-Bacterial Agents, Prevalence, Prospective Studies, Drug Resistance, Bacterial, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male, Young Adult, United Kingdom