Early Switch from IV to Oral Meds Is Effective for Children with Acute Bone Infection
In addition, the oral drugs are more convenient for children and families, and avoid a major drawback of IV use: increased risk of complications from using central catheters, such as infections or breaks in the catheter.
A study team from The Children’s Hospital of
Acute osteomyelitis annually affects at least one in 5,000 children under age 13 in
The traditional treatment has been to supply antibiotics through a central venous catheter over a four- to six-week period after the child returns home from the hospital. Alternatively, children are first treated with IV antibiotics for less than a week, then sent home with oral antibiotics.
In the current study, some 5 percent of the 1,021 children receiving the prolonged IV antibiotic had to return to the hospital for further treatment, compared to 4 percent of the 948 children receiving oral medicine. “The risk of treatment failure was not significantly different between the two groups,” said Zaoutis. “But approximately 4 percent of the children receiving the prolonged IV therapy had complications related to the central venous catheter.”
Zaoutis’s study found wide variability in hospital practices, with some children’s hospitals switching over 90 percent of their osteomyelitis patients to oral drugs, and other hospitals using early transition in less than 10 percent of patients. “This study provides evidence that hospitals can orient their clinical guidelines toward early transition to oral medication for acute osteomyelitis in children,” added Zaoutis. He cautioned that the study focused on children with uncomplicated infections, and switching to oral therapy may not be appropriate for complicated infections or chronic osteomyelitis.
Zaoutis receives support from the National Institutes of Health, and the Agency for Healthcare Research and Quality provided grant support for this research. Zaoutis’s co-authors were
About The Children’s Hospital of
Contact: John Ascenzi The Children's Hospital of Philadelphia Phone: (267) 426-6055 Ascenzi@email.chop.edu
SOURCE The Children’s Hospital of