Oral antibiotics with excellent bioavailability have potential use in managing osteomyelitis, and benefits include reduction in overall treatment cost and complications related to intravenous catheters. Some trials of oral fluoroquinolone therapy suggest similar efficacy with parenteral regimens, particularly when the pathogen is a gram-negative bacillus. However, oral fluoroquinolones appear less successful against S. aureus and Pseudomonas aeruginosa. Other oral antibiotics with good bioavailability that have been considered for osteomyelitis include clindamycin, co-trimoxazole, and some beta-lactams.

Some authors suggest switching to oral antibiotics after an initial 2 weeks of parenteral treatment. A drawback of oral treatment may be the potential for decreased compliance as compared with parenteral treatment. Close follow-up is recommended. Nevertheless, there are few controlled trials comparing oral and parenteral treatments for most clinical situations.

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