The choice of empiric antibiotics should be made based on the most common etiologic organisms given the patient’s demographics, medical history, and risk factors, as well as local antibiotic resistance patterns. Familiarity with an individual hospital’s antibiogram is useful. Gram stain from drained and sampled material can be useful, providing prompt information regarding possible etiologies and choice of antibiotic therapy while awaiting culture results. After an adequate sample of bone tissue is acquired, intravenous antibiotics should be started. The most common bacteria causing osteomyelitis for various age groups as well as suggested antibiotic choices are noted in Table 1. Treatment of osteomyelitis with systemic antibiotics reduces longterm complications of the disease (including growth plate damage, deformity, limb-length discrepancy, pathologic fracture, and loss of life or limb).
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