Men's Osteoporosis Support GroupSpiramycin for bisphosphonate-associated osteonecrosis of the jaw Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):619-26. Clinical experience with spiramycin in bisphosphonate-associated osteonecrosis of the jaw. Gasparini G and others. PMID: 20646357. This is an Italian study involving 25 patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Thirteen patients had taken bisphosphonates for osteoporosis and 12 for malignancies. Twelve individuals who had no previous treatment were divided into equal groups of six. One group got spiramycin and the other got amoxicillin and clavulanic acid (ACA). Although both groups had positive benefits, the authors note that, ". . .spiramycin showed itself to be more effective than the combination of amoxicillin and clavulanic acid." They also suggest, "The results showed that spiramycin can be a first choice drug in the treatment of BRONJ, and it should be strongly considered for patients where previous antibiotic therapy did not prove to be effective." Editor's comments. This is the first article I've seen on BRONJ that suggested a particular antibiotic as being effective for treatment. Unfortunately spiramycin is not currently available in the United States, but is in both Canada and Mexico, and could possibly be obtained from there. This could be necessary if other antibiotics prove ineffective. There are also some BRONJ cases that have a sterile form of osteonecrosis, and antibiotics would thus not be needed. For more on this topic see this Update, or search for others on this site with FreeFind.
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