Simplifying the Treatment of Acute Bacterial Bone and Joint Infections in Children

Markus Pääkkönen; Heikki Peltola

Disclosures

Expert Rev Anti Infect Ther. 2011;9(12):1125-1131. 

In This Article

Length of Treatment

An intravenous phase for 1–2 weeks, followed by course completion for several weeks, resources permitting, is how most osteoarticular infections are treated today worldwide.[1,2,6,30,34] Again, this practice is based solely on retrospective analyses and expert opinions, because until recently, no prospective, randomized and sufficiently powered study has been available.[35]

In our Medline search for prospective treatment trials focusing on antibiotic treatment on OM or SA from the past 20 years, only three studies plus our own trial were found. A small randomized trial on 33 patients concluded that an initial intravenous phase for 10 days in OM and 7 days in SA sufficed before switching to oral medication.[36] Another series (n = 70) shortened the intravenous phase in OM to 7 days,[37] finally, another trial shortened the intravenous phase to 3 days in 59% and for 5 days in 86% of cases.[38] A large retrospective survey of 1969 children from the USA showed no disadvantage of quick switch to oral administration.[39] Some current recommendations for OM and SA are listed in Table 1.[9,10,36–38,40,41] The treatment for OM+SA has usually followed the lines of OM.

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