[French nationwide survey about management of acute osteomyelitis in children].
OBJECTIVE
The outcome of acute osteomyelitis in children has been modified by the use of potent antibiotics. However, treatment management remains unclear. The aim of this study was to investigate the current management of acute osteomyelitis in children in France.


METHODS
A questionnaire regarding the choice and the duration of antibiotics was sent to French pediatricians and pediatric orthopedists.


RESULTS
Ninety-four centers answered the questionnaire: 72 pediatricians and 22 pediatric orthopedists. The response rate was 51% and the median number of children hospitalized per year for osteomyelitis was 4 in each center. The radiologic procedures most often used for diagnosis were X-rays (99%) and bone scintigraphy (82%). Two intravenous antibiotics schemes were used by 80% of centers: either an association of 3rd-generation cephalosporin plus fosfomycin or an association of penicillin M and aminoglycoside, followed by oral penicillin M or pristinamycin. Intravenous therapy lasted 7 to 14 days in 72% of the centers. The total duration of antibiotic therapy was 6 weeks for 55% of centers. In 83% of cases, immobilization was prescribed. The decision for treatment withdrawal was based on clinical, biological or empirical findings for 59, 75 and 60% of departments, respectively.


CONCLUSIONS
In spite of controversies and lack of consensus, regarding both the diagnostic procedures and treatment management, 2 main antibiotic therapy schemes emerged from our survey. However, the treatment duration appeared more variable. Reaching a consensus for acute-osteomyelitis care in children remains a critical issue.
Milcent
K
K
Service de pédiatrie générale, rhumatologie pédiatrique, centre de références des maladies auto-inflammatoires, CHU de Kremlin-Bicêtre, Assistance publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
Guitton
C
C
Koné-Paut
I
I
D000208:Acute Disease; D000284:Administration, Oral; D000367:Age Factors; D000617:Aminoglycosides / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005578:Fosfomycin / Q000008:administration & dosage / Q000627:therapeutic use; D005602:France; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D009985:Orthopedics; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010372:Pediatrics; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D025762:Pristinamycin / Q000008:administration & dosage / Q000627:therapeutic use; D011859:Radiography; D011877:Radionuclide Imaging; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D025762:Pristinamycin; D005578:Fosfomycin