Antibiotics for treating osteomyelitis in people with sickle cell disease

Martí-Carvajal AJ, Agreda-Pérez LH

Published Online:

February 16, 2011

Sickle cell disease affects millions of people throughout the world. Osteomyelitis, a bone infection, is one of the major complications. Antibiotics are given to treat it, but there is no worldwide standard treatment. We did an update of search randomised controlled trials which compared antibiotics (alone or in combination) with other antibiotics. We wanted to know if the different antibiotic treatments were effective, if they were safe, and which doses worked best for osteomyelitis in people with sickle cell disease. This update did not find any trials to include in this review. We conclude that a randomised controlled trial should attempt to answer these questions.

Abstract (click to read)

Background:

Osteomyelitis (both acute and chronic) is one of the most common infectious complications in people with sickle cell disease. There is no standardized approach to antibiotic therapy and treatment is likely to vary from country to country. Thus, there is a need to identify the efficacy and safety of different antibiotic treatment approaches for people with sickle cell disease suffering from osteomyelitis.

Objectives:

To determine whether an empirical antibiotic treatment approach (monotherapy or combination therapy) is effective and safe as compared to pathogen-directed antibiotic treatment and whether this effectiveness and safety is dependent on different treatment regimens, age or setting.

Search strategy:

We searched The Group's Haemoglobinopathies Trials Register, which comprises references identified from comprehensive electronic database searches and handsearching of relevant journals and abstract books of conference proceedings. We also searched the LILACS database (1982 to 11 November 2010), African Index Medicus (11 November 2010), ISI Web of Knowledge (11 November 2010) and World Health Organization International Clinical Trials Registry Platform (11 November 2010).

Date of most recent search of the Haemoglobinopathies Trials Register: 08 December 2010.

Selection criteria:

We searched for published or unpublished randomised and quasi-randomised controlled trials.

Data collection and analysis:

Each author intended to independently extract data and assess trial quality by standard Cochrane Collaboration methodologies, but no eligible randomised controlled trials were identified.

Main results:

This update was unable to find any randomised or quasi-randomised controlled trials on antibiotic treatment approaches for osteomyelitis in people with sickle cell disease.

Authors' conclusions:

We were unable to identify any relevant trials on the efficacy and safety of the antibiotic treatment approaches for people with sickle cell disease suffering from osteomyelitis. Randomised controlled trials are needed to establish the optimum antibiotic treatment for this condition.

This record should be cited as:

Martí-Carvajal AJ, Agreda-Pérez LH. Antibiotics for treating osteomyelitis in people with sickle cell disease. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD007175. DOI: 10.1002/14651858.CD007175.pub2

Assessed as up to date:

December 13, 2010

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Primary Review Group:

Cystic Fibrosis and Genetic Disorders Group

Health topics:

Blood disorders > Genetic disorders > Sickle cell disease: antibiotic treatment

Genetic disorders > Sickle cell disease > Antibiotic treatment

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Antibiotics for treating osteomyelitis in people with sickle cell disease

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