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  1. Home
  2. Management And Outcomes Of Paediatric Bone And Joint Infections In A Regional Australian Hospital: A 10-year Retrospective Study.
  1. Home
  2. Management And Outcomes Of Paediatric Bone And Joint Infections In A Regional Australian Hospital: A 10-year Retrospective Study.

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Management and Outcomes of Paediatric Bone and Joint Infections in a Regional Australian Hospital: A 10-Year

Niall Johnston1, Rani Bhatia2,3, Coen Butters1,4

  • 1Department of General Paediatric and Adolescent Medicine, John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia.

Journal of Paediatrics and Child Health
|January 22, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

Paediatric bone and joint infections (BJI) are common in young Indigenous children. Many received suboptimal oral antibiotic doses, indicating a need for standardized weight-based dosing guidelines for paediatric BJI.

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Area of Science:

  • Paediatric infectious diseases
  • Musculoskeletal infections
  • Antimicrobial stewardship

Background:

  • Bone and joint infections (BJI) are significant causes of morbidity in children.
  • Optimal management of paediatric BJI requires adherence to evidence-based guidelines.
  • Regional Australian hospitals serve diverse populations, including Indigenous children who may have unique health needs.

Purpose of the Study:

  • To evaluate clinical features, management, and outcomes of paediatric bone and joint infections (BJI) in a regional Australian hospital.
  • To assess the appropriateness of weight-based oral antibiotic prescribing for paediatric BJI.
  • To identify disparities in BJI occurrence and management among different demographic groups.

Main Methods:

  • Retrospective study of 171 children (0-18 years) with septic arthritis and/or osteomyelitis (2011-2021).
  • Data extracted on clinical presentation, microbiology, and treatment from medical records.
  • Oral antibiotic doses evaluated against international evidence-based guidelines.
  • Main Results:

    • Paediatric BJI predominantly affected children under 5 years (59.6%) and Aboriginal and Torres Strait Islander children (13.5%).
    • Staphylococcus aureus and Kingella kingae were common pathogens.
    • 43.3% of patients received oral antibiotic doses below guideline recommendations, particularly amoxicillin-clavulanate and cephalexin.

    Conclusions:

    • Paediatric BJI disproportionately affects young and Indigenous children in regional Australia.
    • Suboptimal oral antibiotic dosing is a concern, highlighting the need for standardized weight-based dosing protocols.
    • Further research is warranted to optimize antibiotic dosing strategies for paediatric BJI to improve outcomes.