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Early Antibiotic Discontinuation in Pediatric Suspected Septic Arthritis With No Pathogen Identified: Results of a

Yannis Lassoued1, Cindy Mallet2, Philippe Bidet3

  • 1Department of General Pediatrics, Pediatric Infectious Diseases and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

Journal of the Pediatric Infectious Diseases Society
|September 5, 2025
PubMed

Insights

Early antibiotic discontinuation in children with suspected septic arthritis is safe. This approach, based on strict criteria, did not lead to relapse and reduced unnecessary antibiotic exposure.

Area of Science:

  • Pediatric infectious diseases
  • Clinical microbiology
  • Antimicrobial stewardship

Background:

  • Septic arthritis in children requires prompt treatment.
  • Unidentified pathogens in suspected septic arthritis pose a treatment dilemma.
  • Prolonged antibiotic use carries risks.

Purpose of the Study:

  • To evaluate the safety of early antibiotic discontinuation in children with suspected septic arthritis and no identified pathogen.
  • To assess the rate of relapse after early antibiotic cessation.
  • To determine if this strategy reduces antibiotic exposure.

Main Methods:

  • Observational study over 6 years.
  • Included 45 children with suspected septic arthritis.
  • Early antibiotic discontinuation based on strict clinical and biological criteria.

Main Results:

  • No relapse observed in the six-month follow-up period.
  • Early discontinuation was not associated with adverse outcomes.
  • Supports the safety of the early cessation strategy.

Conclusions:

  • Early antibiotic discontinuation in pediatric septic arthritis is a safe and viable strategy when strict criteria are met.
  • This approach can significantly reduce unnecessary antibiotic exposure.
  • Further research can explore wider application in pediatric infectious disease management.

Keywords:
antibiotic discontinuationantibiotic stewardshipbone and joint infections in childrenmolecular diagnosticspresumed septic arthritis

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