PEDIATRICS Vol. 65 No. 5 May 1980, pp. 867-871
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Oral Antibiotic Therapy of Skeletal Infections in Children

E. Kolyvas MD1, G. Ahronheim MD1, M. I. Marks MD1, R. Gledhill MD1, H. Owen MD1, and L. Rosenthall MD1

1 Divisions of Infectious Diseases, Orthopedics and General Surgery, Montreal Children's Hospital; the Division of Nuclear Medicine, Montreal General Hospital; and the Departments of Paediatrics, Surgery, and Radiology, McGill University, Montreal

Oral and intravenous (IV) antibiotic regimens were compared in 15 children with etiologically defined osteomyelitis and/or septic arthritis. On admission all children were started on standard IV therapy; seven were changed to oral antibiotics within 72 hours and the remaining eight continued on IV therapy for four weeks. Oral antibiotic doses were adjusted to achieve a peak serum bactericidal titer of [unknown]1:8 against the patient's own pathogen. All patients were treated in hospital for four weeks; therapy continued for a minimum of six weeks or until the erythrocyte sedimentation rate (ESR) fell below 20 mm/hr. The clinical course and outcome were similar in both groups. There were no treatment failures nor any relapses during a 12-month follow-up period. This prospective study supports, with controlled data, the concept that acute skeletal infections can be safely and successfully treated with carefully monitored oral therapy.

Submitted on July 9, 1979
Accepted on August 10, 1979




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