The epidemiology and management of chronic osteomyelitis in pediatrics - A systematic review
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View abstract on PubMed
Summary
This summary is machine-generated.This study reviewed evidence on pediatric chronic osteomyelitis (CO), finding poor quality data. While Staphylococcus aureus is a common pathogen, prolonged antibiotic courses do not appear to prevent recurrences.
Area Of Science
- Orthopedics
- Infectious Diseases
- Pediatric Medicine
Background
- Chronic osteomyelitis (CO) in children can result from bone infection and lead to lasting orthopedic issues.
- Optimal management guidelines for pediatric CO are currently lacking.
- This study addresses the need for evidence-based understanding of pediatric CO epidemiology and treatment.
Purpose Of The Study
- To systematically analyze published evidence regarding the epidemiology of pediatric chronic osteomyelitis.
- To evaluate the current management strategies for pediatric chronic osteomyelitis based on available literature.
- To identify gaps in research and inform future high-quality studies.
Main Methods
- A comprehensive literature search was conducted across multiple databases (Ovid Medline, Embase, CINAHL, Scopus) from 1989 to 2025.
- Inclusion criteria focused on studies with a minimum of two pediatric patients (up to 17 years) detailing CO epidemiology or management.
- Quality assessment evaluated bias for management decisions; studies were stratified by country income level, extracting data on demographics, pathogens, treatments, and outcomes.
Main Results
- Forty-one studies were included, with 26 from high-income and 15 from lower-income countries, encompassing 904 and 975 cases, respectively.
- Staphylococcus aureus was the most common pathogen (74% of single-pathogen cases); tibia and femur were most frequently affected.
- Debridement followed by systemic antibiotics (IV/PO) was a common treatment, but study heterogeneity limited direct comparisons; no clear link between antibiotic regimen and recurrence/sequelae was found.
Conclusions
- There is a critical need for high-quality research into the diagnosis and treatment of pediatric chronic osteomyelitis.
- Empirical antibiotic therapy should target Staphylococcus aureus.
- Current evidence does not support the use of prolonged antibiotic courses to prevent CO recurrences.
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