Management of Pseudomonas Osteochondritis Complicating Puncture Wounds of the Foot

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Abstract
Pseudomonas osteochondritis following puncture wounds of the foot is described in 13 children. All children had received at least 1 oral antibiotic and local wound therapy before admission; none had improved on these modalities. P. aeruginosa was isolated alone from 7 patients and with 1 or more other organisms from 6 patients. Initial administration of parenteral antibiotics active against Pseudomonas for 1-14 days did not result in clinical improvement. Eradication of Pseudomonas osteochondritis occurred in each patient only after thorough surgical debridement and curettage of all infected tissue. Following thorough surgical debridement, anti-Pseudomonas antibiotic therapy was continued for 5-14 days (10.8 .+-. 2.7 days). The successful treatment of Pseudomonas osteochondritis should include adequate surgical debridement of all infected tissue; following thorough debridement, only 1-2 wk of anti-Pseudomonas antibiotic therapy appears to be necessary.

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