Management of Osteoarticular Infections Caused by Staphylococcus aureus Is Similar to That of Other Etiologies: Analysis of 199 Staphylococcal Bone and Joint Infections

The Pediatric Infectious Disease Journal, 05/03/2012

Paakkonen M et al. – Osteoarticular infections of childhood caused by methicillin–susceptible S. aureus can be treated according to the same protocol as those used for infections caused by other agents.

Methods

  • The authors prospective treatment trial of children aged 3 months to 15 years included 199 cases of S. aureus osteomyelitis, septic arthritis, or their combination.
  • These cases were compared with 66 cases caused by other agents, mainly Haemophilus influenzae type b, Streptococcus pneumoniae, or Streptococcus pyogenes.
  • According to protocol, the treatment was initiated intravenously only for 2 to 4 days and completed orally.
  • Nonstaphylococcal and staphylococcal infections were treated similarly.
  • Primary antibiotics were clindamycin or a first-generation cephalosporin. Follow-up lasted >12 months posthospitalization.

Results

  • Staphylococcal infections did not significantly differ in the duration of medication, hospital stay, surgery performed, or the number of sequelae when compared with the other etiologic groups.
  • One child with S. aureus arthritis developed 2 late infections by other agents in the same anatomic site.
  • Except 3 mild sequelae (2 caused by S. aureus and 1 by S. pyogenes) 12 months posthospitalization, all patients recovered completely.

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