PMID: 9190554Jun 1, 1997Paper

Simplified treatment of acute staphylococcal osteomyelitis of childhood. The Finnish Study Group

Pediatrics
Heikki PeltolaM J Kallio

Abstract

Recommendations on treatment of acute staphylococcal osteomyelitis of children, based mostly on retrospective analyses, comprise surgical drainage, up to 6 weeks fo antimicrobials guided by the erythrocyte sedimentation rate, and the possibility of switching to the oral route only if monitoring of serum bactericidal titer is guaranteed. A prospective study was conducted to test whether the treatment could be simplified. Fifty pediatric cases of acute Staphylococcus aureus osteomyelitis were randomized to receive 150 mg/kg/day of cephradine divided in four doses, or 40 mg/kg/day in four doses of clindamycin. The treatment was initiated intravenously, but switched to oral administration mostly within 4 days, using the same doses. The peak antimicrobial serum inhibitory titer or bactericidal titer was not measured. The course of illness was monitored by blood leukocytes, erythrocyte sedimentation rate, and serum C-reactive protein. The follow-up was extended to 1 year posthospitalization. Eight tertiary pediatric-orthopedic hospitals in Finland. Full recovery and remaining healthy at least 12 months from hospital discharge. The lower and upper extremities were affected in 72% and 8% of patients, respectively. No surgery at all or ...Continue Reading

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