[Short duration of initial intravenous treatment in 70 pediatric patients with osteoarticular infections].
Osteoarticular infections (OAI) are infrequent in pediatrics and there is controversy on the need for prolonged use of intravenous antimicrobials.


OBJECTIVE
To characterize and describe evolution and complications of a regimen of 7 days initial intravenous antibiotic treatment for OAI in children, completing 4-6 weeks of total treatment.


METHODS
In a large pediatric hospital, 70 children younger than 15 years of age were diagnosed with OAI between March 2003 and December 2004. Children received 7 days of intravenous antibiotics followed by 3 to 5 weeks of oral treatment.


RESULTS
Incidence of OAI in this hospital was 1.8:10000. Patients mean age was 6.4 +/-4.4 years and 60% presented with septic arthritis, 36% osteomyelitis and 4% osteoarthritis. In 80% of cases, the infection was located in the lower extremity. Positive cultures were obtained in 59% predominating Staphylococcus aureus (46.5%). Seven patients had prolonged pain or persistently high or increasing serum C reactive protein levels and were maintained on prolonged intravenous therapy. None of the 63 children with 7 day intravenous antimicrobials nor the 7 children with prolonged intravenous use developed a complication in the short-term follow up.


CONCLUSIONS
Seven days of intravenous antibiotic for the initial phase of OAI treatment was effective in a majority of children and may be recommended.
Prado S
M Alejandra
MA
Unidad de Infectología, Servicio de Pediatría, Hospital Dr. Sótero Del Río, Santiago, Chile.
Lizama C
Macarena
M
Peña D
Anamaría
A
Valenzuela M
César
C
Viviani S
Tamara
T
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001170:Arthritis, Infectious / Q000188:drug therapy*; D002443:Ceftriaxone / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol / Q000008:administration & dosage; D003023:Cloxacillin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006094:Gram-Positive Bacteria / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D010003:Osteoarthritis / Q000188:drug therapy*; D010019:Osteomyelitis / Q000188:drug therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002701:Chloramphenicol; D002443:Ceftriaxone; D003023:Cloxacillin