Systematic review of systemic antibiotic treatment for children with chronic and sub-acute pyogenic osteomyelitis
Article first published online: 3 SEP 2010
© 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 46, Issue 12, pages 736–741, December 2010
How to Cite
Howard-Jones, A. R. and Isaacs, D. (2010), Systematic review of systemic antibiotic treatment for children with chronic and sub-acute pyogenic osteomyelitis. Journal of Paediatrics and Child Health, 46: 736–741. doi: 10.1111/j.1440-1754.2010.01831.x
- Issue published online: 20 DEC 2010
- Article first published online: 3 SEP 2010
- Accepted for publication 7 March 2010.
- randomised controlled trial
Background: There is a lack of consensus on the most appropriate antibiotics to treat children with chronic or sub-acute pyogenic bacterial osteomyelitis and on the optimal duration of antibiotic therapy.
Aim: To review the published evidence on the duration of antibiotic therapy and outcomes in children with chronic and sub-acute pyogenic bacterial osteomyelitis.
Methods: Systematic review of the literature.
Results: We found no randomised controlled trials comparing different antibiotic regimens or comparing duration of antibiotic treatment for chronic or sub-acute osteomyelitis in children. We found 14 observational case series published between 1973 and 2008. Most children with chronic osteomyelitis received 4–6 weeks of parenteral antibiotics followed by oral antibiotics to a total duration of 3–6 months. Small observational studies suggest that a shorter duration of parenteral and oral antibiotics may be equally effective.
Conclusion: There is no high level evidence on the optimal duration of parenteral and oral antibiotics for children with chronic or sub-acute osteomyelitis. A large randomised controlled trial is needed comparing short course parenteral and oral antibiotics with longer antibiotic duration.