The role of oral amoxicillin/clavulanic acid in the treatment of osteomyelitis: a systematic review
Abstract
Purpose: Osteomyelitis continues to pose significant challenges in clinical management, with no universally accepted treatment guidelines at either national or international level as of 2025. Amoxicillin/clavulanic acid (AMC) is a widely used β-lactam antibiotic known for its safety, tolerability, and broad-spectrum activity against common osteomyelitis pathogens. This work seeks to determine whether oral AMC could serve as a viable and effective option in the management of osteomyelitis based on the current treatment landscape of osteomyelitis.
Methods: Preferred Reporting Items for Systematic Reviews (PRISMA) were applied during the preparation of the article. For the structured search in PubMed®, The Cochrane Library, and UpToDate®, key research questions were defined and translated into specific search terms. Inclusion and exclusion criteria were defined using the population-intervention-comparison-outcome-study design strategy. All relevant publications available from 1981 to March 2025 were considered.
Results: A total of 1,321 publications were identified. After applying in- and exclusion criteria - supported by automation tools - 104 publications were analysed. The number of primary studies specifically investigating AMC for osteomyelitis is limited. However, available data suggest that AMC is effective and demonstrates non-inferiority compared to standard reference antibiotics. Pharmacokinetic data indicate that prolonged and repeated dosing may enhance distribution…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.