Osteomyelitis (OM)

Osteomyelitis (OM)


  • Caused by microorganisms that seed the bone in the setting of bacteremia
  • Patients may present following clearance of bacteremia so cultures are not always positive
  • More common in children vs adults
  • Vertebral OM is most common hematogenous OM in adults
  • Result of contiguous spread of infection to bone from adjacent soft tissues and from septic arthritis


  • Via direct inoculation of infection into the bone (as a result of trauma, bite wounds, or surgery)


  • Evidence of MRSA infection elsewhere
  • Nasal colonization with MRSA
  • Recent hospitalization
  • Hemodialysis
  • Injection drug use
  • HIV infection
  • Recent antibiotic use (especially IV in the last 3 months)
  • Sharing sports equipment/contact sports

Additional Information

Guideline originally sourced from Markham Stouffville Hospital and adapted by Joseph Brant Hospital

  • Berbari EF, Kanj SS, Kowalski TJ, et al. 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis. 2015;61(6):e26-e46.

  • The Johns Hopkins University (2020) John Hopkins ABX Guide (1.27) [Mobile App] Retrieved from:

  • Antimicrobial Therapy Inc (2020) The Sanford Guide (4.2) [Mobile App] Retrieved from:

Approved June 2020