Reduced incidence of septic arthritis in children by Haemophilus influenzae type-b vaccination. Implications for treatment.
In many countries Haemophilus influenzae type b (Hib) is the second most common cause of septic arthritis in children. In Finland large-scale immunisation against Hib using conjugate vaccines began in 1986, four years after a multicentre prospective study of orthopaedic infections in children had started. Since 1982, including six years before and ten after starting routine Hib vaccination, there has been a major change in the pattern of septic arthritis. From 1982 to 1988, 32 of 61 cases (53%) were caused by staphylococci, 22 (36%) by Hib and 7 (11%) by other bacteria. Since 1988, Hib infection has disappeared, and one-third of cases of childhood septic arthritis has been eliminated. This change has allowed us to reduce initial antimicrobial therapy for such children to cover only Gram-positive cocci. The more limited treatment is safer, reduces cost, and simplifies treatment.
Peltola
H
H
University of Helsinki, Finland.
Kallio
M J
MJ
Unkila-Kallio
L
L
D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000517:prevention & control*; D002511:Cephalosporins / Q000191:economics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002981:Clindamycin / Q000191:economics / Q000627:therapeutic use; D003363:Cost Control; D004168:Diphtheria Toxoid / Q000008:administration & dosage; D005387:Finland; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006192:Haemophilus Infections / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000008:administration & dosage; D019741:Haemophilus influenzae type b; D006801:Humans; D007114:Immunization; D015994:Incidence; D007223:Infant; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D012449:Safety; D013203:Staphylococcal Infections / Q000188:drug therapy; D013745:Tetanus Toxoid / Q000008:administration & dosage; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D004168:Diphtheria Toxoid; D018073:Haemophilus Vaccines; D013745:Tetanus Toxoid; D018074:Vaccines, Conjugate; D002981:Clindamycin