Three patients with diffuse sclerosing osteomyelitis of the mandible who had been treated by intra-arterial infusion of urokinase and antibacterial agents including fosfomycin were evaluated. All patients underwent decortication at the same time. They were all free from symptoms an average of 3 years 7 months after treatment.
Urokinase and fosfomycin may cause the dissolution of biofilm, which prevents contact between antibacterial agents and causative organism. Thus, the intra-arterial infusion of urokinase, fosfomycin, and other antibacterial agents can efficiently eradicate bacteria in sclerotic bone in osteomyelitis.
