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Intravenous versus oral outpatient antibiotic therapy for pediatric acute osteomyelitis

Raymond W Liu1, Hadeel Abaza, Priyesh Mehta

  • 1Study performed at the Department of Pediatric Orthopaedic Surgery, Case Western Reserve University, University Hospitals Case Medical Center , Cleveland , OH.

The Iowa Orthopaedic Journal
|September 13, 2013
PubMed

Insights

The optimal antibiotic route for pediatric acute osteomyelitis remains unclear. Early oral antibiotic therapy may reduce complications and recurrence compared to intravenous administration.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pharmacology

Background:

  • Acute osteomyelitis in children requires effective antibiotic treatment.
  • The optimal route of antibiotic administration (oral vs. intravenous) is not well-established.
  • Current practices vary, impacting patient outcomes.

Purpose of the Study:

  • To compare outcomes of antibiotic administration routes in pediatric acute osteomyelitis.
  • To evaluate recurrence and complication rates based on treatment settings.
  • To inform optimal therapeutic strategies for pediatric bone infections.

Main Methods:

  • Retrospective analysis of 95 children with acute osteomyelitis.
  • Comparison of treatment at a university hospital (high IV use) versus a county hospital (lower IV use).
  • Data collected on antibiotic routes, recurrence, and line complications.

Main Results:

  • University hospital: 95% IV antibiotics at discharge; 10% recurrence, 24% line complications.
  • County hospital: 65% IV antibiotics at discharge; 0% recurrence, 6% line complications.
  • Significant differences in IV use (P=0.002) and trends in recurrence/complications.

Conclusions:

  • Lower rates of intravenous antibiotic use at discharge correlated with better outcomes.
  • Early oral antibiotic therapy warrants prospective investigation for pediatric acute osteomyelitis.
  • Optimizing antibiotic routes may improve pediatric osteomyelitis management.

Keywords:
intravenous antibioticsoral antibioticspediatric acute osteomyelitis

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