title: Efficacy and safety of sequential treatment with parenteral sulbactam/ampicillin and oral sultamicillin for skeletal infections in children.
abstract: Nine children with osteomyelitis and/or septic arthritis were treated sequentially with parenteral sulbactam/ampicillin and oral sultamicillin. Causative pathogens were identified in six cases; all were susceptible to the combination of ampicillin and sulbactam. The mean duration of parenteral therapy was 7.1 days (6-11 days), and the average hospital stay was 10.3 days (6-18 days). Peak serum bactericidal titers of greater than or equal to 1:8 were achieved in all patients during parenteral therapy; only one child receiving oral therapy did not achieve a titer of greater than or equal to 1:4. At follow-up, all of the children were cured clinically and there was no evidence of relapse. Adverse reactions to oral therapy were minimal. The regimen of parenteral sulbactam/ampicillin and oral sultamicillin used sequentially is effective and safe for the treatment of skeletal infections in children. The use of this approach significantly reduced the duration of hospitalization.
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000667:Ampicillin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy*; D001424:Bacterial Infections / Q000188:drug therapy; D002648:Child; D004338:Drug Combinations / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy; D006193:Haemophilus influenzae / Q000187:drug effects; D006801:Humans; D007223:Infant; D007263:Infusions, Parenteral; D008297:Male; D010019:Osteomyelitis / Q000188:drug therapy*; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000187:drug effects; D013407:Sulbactam
chemical_list: D004338:Drug Combinations; C035444:sultamicillin; D000667:Ampicillin; D010397:Penicillanic Acid; D013407:Sulbactam