Continuous infusion of nafcillin for sternal osteomyelitis in an infant after cardiac surgery

Area of Science:

• Pediatric Infectious Diseases
• Surgical Infections
• Pharmacology

Background:

• Sternal osteomyelitis in infants can be a severe complication, particularly post-cardiac surgery.
• Methicillin-susceptible Staphylococcus aureus (MSSA) is a common pathogen in pediatric bone infections.
• Traditional intermittent dosing of nafcillin may be insufficient for deep-seated infections like osteomyelitis.

Observation:

• An infant patient presented with sternal osteomyelitis due to MSSA.
• The infection was refractory to conventional, intermittent nafcillin therapy.
• The treatment regimen was modified to include continuous infusion of nafcillin.

Findings:

• The combination of surgical debridement and continuous nafcillin infusion led to successful treatment.
• This approach effectively managed the severe pediatric sternal osteomyelitis.
• No adverse events related to the continuous infusion were reported in this case.

Implications:

• Continuous infusion of nafcillin may be a viable and effective strategy for treating resistant pediatric sternal osteomyelitis.
• This case highlights the potential benefits of optimizing antibiotic delivery methods in challenging pediatric infections.
• Further research into continuous infusion antibiotic protocols for pediatric osteomyelitis is warranted.