• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Infectious Disease

Oral antibiotics may be noninferior to intravenous in pediatric acute osteomyelitis

byShayna BejaimalandJames Jiang
December 17, 2014
in Infectious Disease
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Postdischarge oral antibiotic therapy for acute osteomyelitis in children did not result in more treatment failure as compared to intravenous antibiotics.

2. Children treated with intravenous antibiotics through a peripherally inserted central catheter (PICC) line had a higher risk of requiring an emergency department visit or hospitalization due to PICC line complications.

Evidence Rating Level: 2 (Good)

Study Rundown: Acute osteomyelitis is a serious bacterial infection that often requires a 4 to 6 week course of antibiotic therapy once discharged. Generally these antibiotics are administered through a peripherally inserted central catheter (PICC) line. However, PICC lines can be complicated by infection or thrombotic occlusion. Oral antibiotic treatment is a good alternative, but evidence of its efficacy is unclear. This study aimed to compare the effectiveness and adverse outcomes of oral and intravenous postdischarge antibiotics in children with acute osteomyelitis.

Use of oral antibiotics after discharge was not associated with a higher rate of treatment failure compared to intravenous therapy via a PICC line. Children in the PICC line group had a higher rate of any adverse outcome in both within-hospital and across-hospital matched analyses. In stratified analyses, children 5 years and older had an increased risk for treatment failure if they received antibiotics via the PICC line. No deaths occurred in either group.

Strengths of this study include use of full medical file review to validate the exposure and outcome variables as well as allowing the authors to adjust for many covariates. This study also uses propensity-score full matching, allowing balancing of patient-level variables across both exposure groups. However, weaknesses in this study include a high percentage of exclusions (76%) from initial patient population, resulting in a generally decreased sample size. In addition to the regular biases that occur in observational studies, it is unclear if this excluded population differs significantly from the studied population.

Click to read the study, published in JAMA Pediatrics

RELATED REPORTS

Addition of azithromycin to standard treatment does not improve survival in childhood diarrhea

#VisualAbstract Drug survival of etanercept was significantly lower than other biologics in patients with hidradenitis suppurativa

7-day antibiotic therapy is noninferior to 14-day therapy in afebrile men with urinary tract infection

Relevant Reading: Acute Osteomyelitis in Children

In-Depth [retrospective cohort]: This retrospective case used the Pediatric Health Information System (PHIS) database cohort of 8,555 children aged 2 months to 18 years old discharged from a PHIS hospital between January 2009 and December 2012 from 38 different hospitals in Kansas. After excluding 6,495 children for numerous reasons (e.g. chronic osteomyelitis, direct admissions from other hospitals, length of stay <2 days or >14 days), 1,005 children who received oral antibiotics and 1,055 children who received parenteral antibiotics were included. The primary outcome was treatment failure as defined by revisits to the emergency department for change in antibiotics, prolongation of antibiotic therapy, conversion from oral to PICC route, and abscess drainage or debridement. Secondary outcomes included adverse drug reactions, PICC complications (infection, thrombosis and repair, adjustment or removal of PICC line) and a composite outcome of the above.

In both across-hospital (risk difference 0.3%, 95%CI -0.1% to 2.5%) and within-hospital (risk difference 0.6%, 95%CI -0.2% to 3.0%) matched analyses, children who received oral antibiotics did not experience more treatment failures than those who were on parenteral antibiotics. Children in the PICC group had a 14% increased risk of requiring a return emergency department visit or rehospitalization due to adverse events when compared to the oral antibiotic group. This result remained robust through both across (risk difference 14.6%, 95%CI 11.3% to 17.9%) and within-hospital (risk difference 14.0%, 95%CI 10.5% to 17.6%) matched analyses.

More from this author: Overall US diet quality improved from 1999 to 2010, Arterial catheter monitoring in ICU not associated with mortality benefit, Maintenance opioids in drug users linked with lower rate of hepatitis C infection, Delayed antiretroviral therapy initiation linked to decreased immunologic recovery in HIV, Multiple factors may increase risk of falls in young children

Image: PD

©2014 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. No article should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2 Minute Medicine, Inc.

Tags: antibiotic
Previous Post

Inflated media health news coverage linked to press release exaggeration

Next Post

Most ovarian cysts resolve, sonographic surveillance recommended [Classics Series]

RelatedReports

Growth Faltering is Associated With Altered Brain Functional Connectivity and Cognitive Outcomes In Urban Bangladeshi Children Exposed to Early Adversity
Pediatrics

Addition of azithromycin to standard treatment does not improve survival in childhood diarrhea

February 18, 2022
#VisualAbstract Drug survival of etanercept was significantly lower than other biologics in patients with hidradenitis suppurativa
StudyGraphics

#VisualAbstract Drug survival of etanercept was significantly lower than other biologics in patients with hidradenitis suppurativa

December 23, 2021
Ultrasound enhances gastrointestinal absorption of drugs at low frequencies
Emergency

7-day antibiotic therapy is noninferior to 14-day therapy in afebrile men with urinary tract infection

July 29, 2021
#VisualAbstract: Ziltivekimab antagonism of IL-6 reduces inflammation and thrombosis in patients with atherosclerotic risk factors
StudyGraphics

#VisualAbstract: Shorter antibiotic therapy for prosthetic joint infection caused worse outcomes

June 16, 2021
Next Post
Classics Series, Landmark Trials in Medicine

Most ovarian cysts resolve, sonographic surveillance recommended [Classics Series]

Imaging of atherosclerotic inflammation possible with fluorine MRI

Imaging of atherosclerotic inflammation possible with fluorine MRI

Pre-operative transcranial magnetic stimulation useful for language mapping

Nanoparticle delivery of proteasomes may improve Alzheimer’s therapy [Pre Clinical]

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Stereotactic body radiotherapy as a state of the art treatment option in inoperable non-small cell lung cancer [Classics Series]
  • Health system-based care associated with better treatment use and high rates of tobacco abstinence at 3 months post-discharge in hospitalized smokers
  • APOEε4 genotype may increase risk of chronic traumatic encephalopathy following repetitive head impact
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.