Organism isolation and serum bactericidal titers in oral antibiotic therapy for pediatric osteomyelitis

Isolation of the etiologic organism and monitoring of serum bactericidal titers are considered necessary in oral antibiotic therapy for osteomyelitis. Over a 5-year period, 26 pediatric patients with hematogenous osteomyelitis were treated with sequential parenteraloral therapy. No organism was isolated in 9 cases, and bactericidal titers were determined in only 7 cases. All patients did well, raising questions about the conventional prerequisites invoked for oral treatment of skeletal infections.