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

Markus Pääkkönen; Heikki Peltola


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.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.