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I am dealing with osteomyelitis again after 20 years. Presently, I am taking vancomycin. I was told that this is a standard drug regime in Utah, and that the medication has been a standard for 50 years. I am not retaining clinical levels that will postively effect the infection. Twenty years ago, in Arizona, I received ciprofloxicin IV with and additional 26 week oral regime. This worked well for 20 years. If vancomycin is standard why didn't the treatment include it in Arizona? Are there different clinical standards in each state for each disease? If so, which state has the best track record for osteomyelitis? What treatment do they use?

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Chronic osteomyelitis requires surgery for cure. This, now, is a biofilm disease and, as such, the levels of antibiotics achieved through systemic treatment prove inadequate to kill the biofilm colony (of organisms). That's why your infection has returned and will continue to return until you have surfaces harboring the biofilm, removed surgically ( see ***edited by moderator*** web addresses not allowed
So far as antibiotics are concerned, both Cipro and Vanc are good choices providing treatment is for a routine, sensitive, Staphylococcus aureus infestation --- there is no gold standard other than to administer antibiotics to which the pathogen is sensitive. "If it fits, it ships!" G. Cierny, MD ***edited by moderator*** web addresses not allowed
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