Manage of acute osteomyelitis in children--should it be conservative?
73 children with acute osteomyelitis seen at King Fahd University Hospital, Al-Khobar, Saudi Arabia were reviewed. Majority of patients were between the 6-10 year age group and male children predominated. All patients had incision and drainage and antibiotic therapy for a minimum of 6 weeks. Metaphysis of the tibia was the commonest site of infection and the staphylococcal species was cultured in 77% of children. Ampiclox was the most sensitive antibiotic. The average follow up was 4.9 years and the incidence of chronic osteomyelitis was 1.75%. In conclusion this study confirms that clinically it is not possible to detect a subperiosteal abscess within the first 48 hours. As blood culture is not 100% reliable in isolating the ineffective organism and incision and drainage plays a double role, firstly in the identification of the offending organism and secondly in the evacuation of pus. A six-week antibiotic therapy is essential to prevent any relapses. The correct management of acute osteomyelitis in children is surgical drainage of the affected site combined with antibiotic therapy.
Sadat-Ali
M
M
College of Medicine and Medical Sciences, King Faisal University, Saudi Arabia.
D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000188:drug therapy* / Q000601:surgery*
D000900:Anti-Bacterial Agents