Dexamethasone Therapy for Septic Arthritis in Children

Pediatrics
Itay FogelLiora Harel

Abstract

Prospective studies of children with septic arthritis report that adding dexamethasone to antibiotic therapy contributes significantly to clinical and laboratory improvement. This study sought to evaluate the effect of this regimen outside of a randomized controlled trial. The sample consisted of children with septic arthritis hospitalized at a tertiary pediatric medical center in 2008 to 2013. Disease course and outcome were compared between children treated with antibiotics alone or with adjuvant dexamethasone, according to the admitting department policy. The cohort included 116 patients, 90 treated with antibiotics alone and 26 treated with antibiotics+dexamethasone. The groups were similar for age, symptom duration before hospitalization, body temperature, acute-phase reactant levels, and rate of positive fluid cultures (21.6% total). Compared with monotherapy, antibiotics+dexamethasone treatment was associated with a shorter duration of fever (mean 2.3 vs 3.9 days, P = .002), more rapid clinical improvement (mean 6.3 vs 10.0 days to no pain/limitation, P < .001), more rapid decrease in C-reactive protein level to <1 mg/dL (mean 5.3 vs 8.4 days, P = .002), shorter duration of parenteral antibiotic treatment (mean 7.1 vs 11...Continue Reading

Citations

Jun 4, 2016·International Journal of Molecular Sciences·Luca CastellazziSusanna Esposito
Jul 15, 2017·The Pediatric Infectious Disease Journal·Jesús Saavedra-LozanoAnton LeMair
Jun 14, 2017·EFORT Open Reviews·Alexios D Iliadis, Manoj Ramachandran
Nov 28, 2018·The Cochrane Database of Systematic Reviews·Mario F Delgado-NogueraJose Andres Calvache
Nov 22, 2018·Current Opinion in Pediatrics·James F Mooney, Robert F Murphy
Oct 1, 2019·The Journal of Bone and Joint Surgery. American Volume·Alexus M CooperJavad Parvizi
Dec 7, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Robert F MurphyJames F Mooney
Jul 2, 2019·Pediatric Emergency Care·Michael GottliebMelissa Rice
May 31, 2019·Current Infectious Disease Reports·Lior Ben-ZviBenjamin Bernfeld
Sep 16, 2016·Expert Review of Anti-infective Therapy·Elena ChiappiniSimone Lazzeri

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