%0 Journal Article
%T Long-term follow-up of jaw osteomyelitis associated with bisphosphonate use in a tertiary-care center.
%A Pigrau-Serrallach C
%A Cabral-Galeano E
%A Almirante-Gragera B
%A Sordé-Masip R
%A Rodriguez-Pardo D
%A Fernandez-Hidalgo N
%A Larrosa-Escartín N
%A Bescos-Atín S
%A Pahissa-Berga A
%J Enferm Infecc Microbiol Clin
%V 32
%N 1
%D Jan 2014
%M 23473675
%F 1.994
%R 10.1016/j.eimc.2013.01.007
%X <B>OBJECTIVE: </B>This study reviews our experience in bisphosphonate-associated jaw osteomyelitis (BJOM), focusing on the incidence, etiology, treatment, and long-term outcome.<BR><B>METHODS: </B>Retrospective review of the clinical histories adult patients diagnosed with BJOM (1995-2008) in a tertiary hospital.<BR><B>RESULTS: </B>BJOM was found in 30 of 132 (22.7%) consecutive patients with jaw osteomyelitis. The percentage of BJOM cases increased from 8.7% (4/46) in 1995-2005 to 30.2% (26/86) in 2005-2008. Symptoms appeared in a median of 2.5 years after intravenous use, and 4.5 years after oral exposure. Viridans group streptococci were isolated in 83.3% of cases. Actinomyces spp. was found in 16 (39.0%) of 41 bone histologies. All included patients received a median of 6 months of appropiate antibiotic therapy and a surgical procedure (debridament and/or sequestrectomy). Thirteen of 27 cases (48.1%) with long-term follow-up (median 22 months, IQR 25-75 17-28) failed. Clinical failure defined as, persistent infection or relapse, was more frequent in patients receiving intravenous than oral bisphosphonates (11/16 [68.8%] vs. 2/11 [18.2%]; P < .05) and in cases with Actinomyces spp. (7/10 [70.0%] vs6/17 [35.3%]; P = .08).<BR><B>CONCLUSIONS: </B>Bisphosphonate therapy is now a frequent cause of JO. BJOM is difficult to cure and relapses are common, particularly in patients exposed to intravenous bisphosphonates.