Penicillin Versus Tetracycline in the Treatment of Childhood Osteomyelitis

Abstract

Summary Fifty‐eight children with acute haema‐togenous osteomyelitis have been studied. The incidence of infection by penicillin‐resistant organisms was found to be 54.5 % in 33 cases in which an organism was recovered. Tetracycline has been found to be more effective than penicillin in the primary treatment of this condition.

The History of Antibiotic Treatment of Osteomyelitis

“…In 1962, Cullen and Hargadon published the first comparative study to support use of tetracyclines for treatment of osteomyelitis, in a retrospective cohort of 55 patients given either oral tetracycline or intramuscular penicillin for 3–4 weeks. They found lower rates of infectious complications such as abscess or sequestra formation in the patients given tetracycline compared with penicillin (15% vs 54%, P = .0049) and higher rates of hospital discharge within 30 days (60% vs 26%, P = .02) [22]. An important caveat of this study was that penicillin-resistant S. aureus accounted for more than half of cases with a microbiologic diagnosis, suggesting that bacterial nonsusceptibility may have confounded the high rates of treatment failure in the penicillin arm.…”