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Comparative Study
. 2002 Aug 14:2:16.
doi: 10.1186/1471-2334-2-16.

Shorter courses of parenteral antibiotic therapy do not appear to influence response rates for children with acute hematogenous osteomyelitis: a systematic review

Nicole Le Saux  1 , Andrew Howard, Nicholas J Barrowman, Isabelle Gaboury, Margaret Sampson, David Moher
Affiliations
Comparative Study

Shorter courses of parenteral antibiotic therapy do not appear to influence response rates for children with acute hematogenous osteomyelitis: a systematic review

Nicole Le Saux et al. BMC Infect Dis. .

Abstract

Background: Acute hematogenous osteomyelitis (AHO) occurs primarily in children and is believed to evolve from bacteremia followed by localization of infection to the metaphysis of bones. Currently, there is no consensus on the route and duration of antimicrobial therapy to treat AHO.

Methods: We conducted a systematic review of a short versus long course of treatment for AHO due primarily to Staphylococcus aureus in children aged 3 months to 16 years. We searched Medline, Embase and the Cochrane trials registry for controlled trials. Clinical cure rate at 6 months was the primary outcome variable, and groups receiving less than 7 days of intravenous therapy were compared with groups receiving one week or longer of intravenous antimicrobials.

Results: 12 eligible prospective studies, one of which was randomized, were identified. The overall cure rate at 6 months for the short course of intravenous therapy was 95.2% (95% CI = 90.4 - 97.7) compared to 98.8% (95% CI = 93.6, 99.8) for the longer course of therapy. There was no significant difference in the duration of oral therapy between the two groups.

Conclusions: Given the potential increased morbidity and cost associated with longer courses of intravenous therapy, this finding should be confirmed through a randomized controlled equivalence trial

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Figures

Figure 1
Figure 1
Flow diagram outlining the results of literature search and review of studies retrieved. *Kaplan [38] is not included in the analysis because it is methodologically dissimilar from the other cohorts
Figure 2
Figure 2
Cure rate versus the duration of parenteral antimicrobial therapy Long-term parenteral antimicrobials is defined as greater than or equal to 7 days. Short-term parenteral antimicrobials is defined as less than 7 days
See this image and copyright information in PMC

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