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Dexamethasone therapy for septic arthritis in children: Results of a randomized double-blind placebo-controlled study
Journal of Pediatric Orthopaedics , 02/15/2011
Clinical Article
Harel L et al. – The authors evaluated the effect of adding dexamethasone to antibiotic therapy in the clinical course of septic arthritis in children. A 4-day course of dexamethasone given at the start of antibiotic treatment in children with septic arthritis, is safe, and leads to a significantly more rapid clinical improvement, shortening duration of hospitalization compared with those treated with antibiotics alone.
Methods- Randomized double-blind placebo-controlled trial
- Study group included 49 children with septicarthritis
- In addition to antibiotic therapy given, patients randomly assigned to receive intravenous dexamethasone 0.15 mg/kg every 6 hours for 4 days or placebo
- Groups compared for clinical and laboratory parameters, length of hospital stay, and late sequelae
- Mean age 33±42 months (range: 6 to 161 mo)
- No significant difference between dexamethasone and placebo groups in age, duration of symptoms, joint affected, or levels of acute phase reactants
- Bacteria isolated from joint fluid in 17 patients (35%) and from blood in 4 patients
- Compared with placebo group, patients treated with dexamethasone had significantly shorter duration of fever (P=0.021; mean first day without fever 1.68 vs 2.83) and local inflammatory signs (P=0.021; mean first day without pain 7.18 vs 10.76), lower levels of acute phase reactants (P=0.003; mean last day of ESR>25 mm/h 3.76 vs 8.40), shorter duration of parenteral antibiotic treatment (P=0.007; mean of 9.91 d vs 12.60 d), and shorter hospital stay
- No side effects of treatment recorded in either group
