Tratamiento intravenoso inicial abreviado en 70 pacientes pediátricos con infecciones osteo-articulares

C, Macarena Lizama; D, Anamaría Peña; M, César Valenzuela; S, Tamara Viviani

doi:10.4067/s0716-10182008000100007

Cited by 13 publications

(17 citation statements)

References 38 publications

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“…Despite the considerable variability in the management of pediatric AHO, a growing body of evidence indicates that a shorter course of intravenous (IV) antibiotic therapy followed by an early transition to oral antibiotic therapy may offer a similar success rate in children with uncomplicated osteomyelitis compared to prolonged IV therapy alone while avoiding the complications related to the use of a venous catheter. [27][28][29][30][31][32][33][34] Studies have documented substantial risks associated with use of prolonged IV therapy for AHO. In a 2006 retrospective cohort study from the United States, of the 75 patients who received prolonged IV therapy (>2 weeks) for AHO, 41% had ࣙ1 central venous catheter (CVC)associated complication.…”

Section: Managementmentioning

confidence: 99%

“…Two additional trials (conducted in Chile and Australia/United Kingdom) that included predominantly MSSA cases also demonstrated no difference in outcomes when the duration of IV antibiotic therapy was <1 week. 33,34 A systematic review from the United Kingdom published in 2013 also concluded that uncomplicated AHO in children >3 months should be treated with 3-4 days of IV antibiotics followed by the transition to oral antibiotics if the child shows a good clinical response. 39 Using higher doses of oral β-lactam antibiotics is crucial to ensure adequate antibiotics levels in the bloodstream (Table 3).…”

Section: Managementmentioning

confidence: 99%

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Acute Hematogenous Osteomyelitis in Children

Thakolkaran¹,

Shetty

2019

TOJ

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Background:The epidemiology of acute hematogenous osteomyelitis (AHO) in children has changed. Methods: We reviewed the current literature regarding the epidemiology, microbiology, pathogenesis, clinical presentation, diagnosis, and antimicrobial management of AHO in children. Results: Staphylococcus aureus is the most common microorganism causing pediatric AHO, followed by group A Streptococcus (GAS). AHO due to community-associated methicillin-resistant Staphylococcus aureus (MRSA) can cause severe and complicated disease. Pathogen isolation by culture is key for targeted antibiotic therapy. Polymerase chain reaction assay in tissue sample or joint fluid may enhance the yield of Kingella kingae. C-reactive protein is useful in diagnosis and monitoring the course of AHO. Magnetic resonance imaging is the preferred diagnostic imaging study for AHO. Clindamycin or vancomycin (for serious disease) is recommended for empiric therapy of suspected AHO due to MRSA depending on the geographic prevalence. Penicillinase-stable penicillins or first-generation cephalosporins are preferred antibiotics to treat methicillin-sensitive S aureus (MSSA) infection. Betalactam agents are the drugs of choice for treating AHO due to K kingae, GAS, or Streptococcus pneumoniae. For uncomplicated AHO due to MSSA, a short parenteral antibiotic course followed by oral therapy for a minimum total duration of 3-4 weeks is adequate. Complicated AHO due to MRSA may warrant prolonged therapy with surgical intervention. Conclusion: Given the evolution of pathogens, the variability in clinical presentations and course ranging from simple to complex disease, and response to treatment, the management of AHO continues to evolve and warrants an individualized, multidisciplinary approach.The nonspecific markers of inflammation-CRP and erythrocyte sedimentation rate (ESR)-are commonly used in the initial evaluation of AHO. 17 CRP has a half-life of 19 hours

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Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Acute Hematogenous Osteomyelitis in Children

Thakolkaran¹,

Shetty

2019

TOJ

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“…En el período de estudio observamos 146 IOA en niños. En nuestra serie se observó predominio del género masculino (60,3%, con una relación masculino:femenino de 1,5:1) lo que es similar a lo descrito en la literatura internacional 1,14 y con una mayor tendencia que la anterior publicación chilena que reportó una relación de 1,04:1 11 . En cuanto a distribución etaria, se vio una mayor incidencia en edad escolar (45% de los casos), difiriendo de lo descrito, tanto en una publicación extranjera -Grammatico-Guillon y cols.…”

Section: Discusión Y Conclusionesunclassified

“…En Chile el último estudio publicado que describe la epidemiología, microbiología local y la evolución de los pacientes con IOA en pediatría data del año 2008 11 . Siendo las IOA un grupo de patologías en que se describe un aumento en la frecuencia de SARM (Stockmann y cols.…”

Section: Introductionunclassified

Infecciones osteoarticulares en niños: experiencia de cinco años

Rodríguez²,

et al. 2020

Rev. chil. infectol.

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“…as infecciones osteo-articulares son una patología relativamente frecuente en pediatría, con una incidencia de 1: 1.000 a 1: 20.000 individuos para osteomielitis y 5,5 a 12: 100.000 para artritis séptica y comprenden tres entidades: artritis séptica, osteomielitis y la combinación de ambas [1][2] . La epidemiología de estas infecciones está cambiando, principalmente a causa de que Staphylococcus aureus resistente a meticilina de la comunidad (SARM-Co) es el agente más frecuente en algunos países de Latinoamérica como Argentina y Uruguay, por ejemplo [2][3][4][5][6] .…”

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