There are a number of treatment options for osteomyelitis. The type of therapy depends on the nature and severity of the infection. Treatments include:

• Antibiotics. Osteomyelitis caused by a bacterial infection is treated with intravenous antibiotics to keep acute osteomyelitis from becoming chronic. In the case of hematogenous osteomyelitis, this treatment may last from two to six weeks. Once the condition has been better controlled, oral antibiotics may be prescribed. In some cases, scraping and irrigation of the bone (debridement) may be considered. The rise of drug-resistant bacteria such as MRSA (methicillin-resistant Staphylococcus aureus) has complicated treatment.
  
  
• Drainage. Pockets of fluid surrounding infected bone (abscesses) may be drained with a needle.
  
  
• Surgery. If the infection already has progressed to the chronic stage, it is often necessary to remove the dead bone through a surgical procedure. Surgery to remove necrotic tissue and improve circulation can prevent extensive amputation later. Once the bone has been removed, it is replaced by a graft or packing material designed to promote the growth of new bone tissue. The patient is likely to remain on antibiotics for at least three weeks after surgery.
  
  
• Hyperbaric (high-pressure) oxygen. Some medical centers offer hyperbaric chambers as an option. High-pressure pure oxygen may promote healing by increasing circulation.  

Orthopedic prosthetics can also lead to infection. Metal surfaces provide an area where the bacteria adhere and multiply as biofilm. The biofilm shields germs from the body’s defenses and antibiotic treatment. It may therefore be necessary to surgically remove the prosthesis and the infected tissue surrounding the area. In some cases, a new prosthesis may be implanted immediately. In cases where the infection is more severe, implantation of the prosthesis may be delayed.

When osteomyelitis is detected early, the prognosis is good. With timely and appropriate treatment, acute osteomyelitis is curable. However, the outlook is much less favorable in cases of chronic osteomyelitis. This is especially true for patients with poor blood circulation due to conditions such as diabetes or peripheral artery disease. In such cases, amputation is frequently necessary.

Complications that may continue with osteomyelitis even after treatment include:

• Progression of acute to chronic osteomyelitis
• Local spread of infection
• Reduced limb or joint function