Therapeutic target
- Elimination of the pathogens
- Avoidance of complications and a chronification
Therapy recommendations
- Symptomatic therapy: analgesia/pain elimination according to WHO staging scheme:
- Non-opioid analgesic (paracetamol, first-line agent).
- Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic.
- High-potency opioid analgesic (eg, morphine) + non-opioid analgesic.
- If necessary, anti-inflammatory drugs (anti-inflammatory drugs; non-steroidal anti-inflammatory drugs, NSAIDs), eg acetylsalicylic acid (ASA), ibuprofen.
- After taking tissue samples, a calculated therapy (mainly beta-lactam antibiotics such as penicillins, cephalosporins, carbapenems, monobactams, clavulanic acid derivatives; clindamycin) is carried out until the antibiogram is available; fastest possible changeover to culture-specific antibiosisThe duration of therapy is usually two weeks in children, four to six weeks in adults.
- Intraoperative storage of antibiotic-loaded PMMA chains (eg, gentamycin) – delivery of the active substance over three weeks.
