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Outpatient Laboratory Monitoring for Antibiotic-related Adverse Events in Children With Acute Hematogenous

Felicia O Rosiji1, Marritta Joseph, Lauren M Sommer

  • 1From the Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.

The Pediatric Infectious Disease Journal
|September 30, 2024
PubMed

Insights

Routine monitoring for antibiotic-related lab abnormalities in pediatric osteomyelitis is common. However, these abnormalities rarely impact treatment, questioning the routine value of such pediatric lab monitoring.

Area of Science:

  • Pediatric infectious diseases
  • Clinical pharmacology
  • Laboratory medicine

Background:

  • Antibiotic-related lab abnormalities (ARLA) are frequently monitored in pediatric osteomyelitis cases.
  • Common toxicities include hematologic, renal, and hepatic effects.

Purpose of the Study:

  • To evaluate the incidence and clinical significance of ARLA in children with osteomyelitis undergoing outpatient monitoring.
  • To assess the impact of ARLA on antibiotic treatment decisions in this population.

Main Methods:

  • Retrospective analysis of 240 pediatric osteomyelitis cases with outpatient laboratory monitoring.
  • Documentation of ARLA occurrences, specific abnormalities (e.g., neutropenia), and impact on antibiotic therapy.

Main Results:

  • ARLA were observed in 13.3% of patients.
  • Neutropenia was the most frequent laboratory abnormality detected.
  • ARLA led to changes in antibiotic therapy in less than 1% of cases.

Conclusions:

  • While ARLA occur in a notable percentage of pediatric osteomyelitis patients, their clinical impact on antibiotic therapy is minimal.
  • The routine use of extensive laboratory monitoring for ARLA in pediatric osteomyelitis warrants re-evaluation due to low clinical significance.

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