Historically, children with acute osteomyelitis and septic arthritis have received lengthy combined antibacterial therapy (intravenous and oral). The authors of a study at Birmingham Children's Hospital in the United Kingdom put forward a hypothesis that a safe and effective treatment of this category of patients with the use of high dose antibacterial drugs for 3 days intravenously followed by a transition to oral antibiotic therapy for three weeks is possible.

A journal published in the August issue of the Journal of Pediatric Orthopedics presents the results of a prospective bicentric study to determine the adequate duration of antibiotic therapy for acute uncomplicated bone infections and joints in children.

The study collected data on children aged 2 weeks to 14 years who were hospitalized for septic arthritis and osteomyelitis for a period of 52 months. Information on children under the age of 16 who were not suffering from the underlying disease and did not receive treatment that may be causing the infection, with symptoms of the disease lasting up to '' at 14 days until hospitalization, were selected from the database. Patients with septic arthritis underwent arthroscopic lavage. All patients received antibiotic therapy according to a predetermined treatment algorithm, i.e. intravenously, and after clinical and hematological improvement, patients were transferred to receive an antibiotic inside. The follow-up period, during which hematological and radiological examinations were carried out on an outpatient basis, lasted 1 year after the end of treatment.

The study analyzed data from 70 patients aged 2 weeks to 14 years. In bacteriological studies of osteomyelitis, only staphylococci were isolated, while streptococci predominated in patients with septic arthritis.

Switching to oral antibiotics in 59% of children could be done after 3 days of intravenous therapy and 86% after 5 days. The average length of stay in hospital was 5 days. The study found that 3 weeks of oral antibiotic therapy was sufficient for patients who received intravenous antibiotics for 5 days or less. The most indicative quantitative markers for monitoring patient response to antibiotic therapy have been shown to be C-reactive proteins and temperature response. During the 1-year follow-up period, all patients experienced persistent clinical, hematological and radiological remission of the disease.

Thus, during the study, it was found that a reduced cycle of intravenous and oral antibacterial therapy is effective in children with acute uncomplicated septic osteomyelitis and arthritis.