title: Oral Ambulatory Treatment of Acute Osteomyelitis in Children: A Case-Control Study.
abstract: The treatment of acute hematogenous osteomyelitis has evolved in recent years to a shorter parenteral treatment with an early switch to the oral route. Current publications recommend a 2- to 4-day parenteral treatment before the oral switch. We retrospectively analyzed a series of 45 children aged 1 to 11 years and treated in our department for acute osteomyelitis without severity criterion. Nineteen of 45 patients were treated by an exclusive ambulatory oral treatment by amoxicillin and clavulanic acid. Twenty six of 45 patients had a 2- to 4-day parenteral treatment before the oral switch. The minimum follow-up was 6 months. The primary endpoint was a clinical, radiographic, and biologic healing, 6 months after the beginning of the treatment. The secondary endpoints evaluated were the length of hospitalization, the total duration of treatment, and the type of antibiotic used. On the primary endpoint, we did not find any significant difference between the 2 treatments (P = 0.38). On the duration of treatment, we found a significant difference (P = 0.049) in favor of oral treatment. The ambulatory oral treatment by amoxicillin and clavulanic acid seems to be a valid alternative to the classical parenteral then oral sequence in the treatment of acute hematogenous osteomyelitis in children without severity criterion.
authors.affiliation: From the *Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie-Paris 6; †Biostatistics and Public Health Department, Pitié-Salpétrière Hospital; and ‡The MAMUTH Hospital-University Department for Innovative Therapies in Musculoskeletal Diseases - Armand Trousseau Hospital, Paris, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Roul-Levy
authors.forename: Vincent
authors.initials: V
authors.lastname: Looten
authors.forename: Manon
authors.initials: M
authors.lastname: Bachy
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Grimprel
authors.forename: Ricardo
authors.initials: R
authors.lastname: Carbajal
authors.forename: Raphaël
authors.initials: R
authors.lastname: Vialle
mesh_terms: D000284:Administration, Oral; D000553:Ambulatory Care; D000658:Amoxicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002969:Clavulanic Acids / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D007263:Infusions, Parenteral; D008297:Male; D010019:Osteomyelitis / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; D000658:Amoxicillin