The effect of vitamin D3 supplementation on chronic osteomyelitis

BACKGROUND: Chronic osteomyelitis is a difficult-to-treat bone infection and has frequent relapses. Vitamin D seems to have systemic antimicrobial properties and increases therapeutic response when administered with appropriate antibiotics. The aim of the present study was to evaluate the effect of vitamin D3 supplementation on chronic osteomyelitis. METHODS: This randomized, blinded, placebo-controlled pilot trial was conducted in Afzalipour Hospital and Besat Clinic affiliated with Kerman University of Medical Sciences, Kerman, Iran, from June 2017 to January 2020. Thirty patients with lower-extremity chronic osteomyelitis were randomly assigned to receive oral vitamin D3 pearls or a placebo. The participants were followed for 6 months. The levels of erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) and the prevalence of osteomyelitis symptoms were recorded at baseline and 1, 3, and 6 months later. SPSS software and statistical tests such as generalized estimating equation (GEE) and mixed model analysis of variance (ANOVA) were used to analyze the data. RESULTS: ESR (P = 0.045), CRP (P = 0.049), and the prevalence of osteomyelitis symptoms significantly decreased in the vitamin D3 group in comparison with the placebo one during the study. CONCLUSION: High-dose and long-term vitamin D3 supplementation as an adjunct therapy to antibiotics may improve the outcomes of patients with chronic osteomyelitis.