Which test is necessary before administering oral antibiotics for osteomyelitis?

For the management of osteomyelitis, obtaining a definitive diagnosis is crucial. A bone biopsy and culture is necessary before initiating oral antibiotics. This procedure allows for the identification of the specific pathogen causing the infection, which is essential for guiding appropriate antibiotic therapy. Culture results help ensure that the prescribed antibiotics are effective against the identified organism, minimizing the risk of treatment failure or complications due to inadequate coverage.

In cases of osteomyelitis, imaging studies such as CT scans or X-rays may be useful for assessing the extent of the infection or evaluating changes in bone structure, but they do not provide definitive information about the causative organism. Serum protein electrophoresis is unrelated to the diagnosis or treatment of osteomyelitis and does not play a role in guiding antibiotic therapy. Therefore, while imaging can support the diagnosis, the confirmation through a bone biopsy and culture is necessary to tailor the treatment effectively.