Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children
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Published:2021-08-28
Issue:1
Volume:47
Page:
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ISSN:1824-7288
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Container-title:Italian Journal of Pediatrics
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language:en
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Short-container-title:Ital J Pediatr
Author:
Krzysztofiak AndrzejORCID, Chiappini Elena, Venturini Elisabetta, Gargiullo Livia, Roversi Marco, Montagnani Carlotta, Bozzola Elena, Chiurchiu Sara, Vecchio Davide, Castagnola Elio, Tomà Paolo, Rossolini Gian Maria, Toniolo Renato Maria, Esposito Susanna, Cirillo Marco, Cardinale Fabio, Novelli Andrea, Beltrami Giovanni, Tagliabue Claudia, Boero Silvio, Deriu Daniele, Bianchini Sonia, Grandin Annalisa, Bosis Samantha, Ciarcià Martina, Ciofi Daniele, Tersigni Chiara, Bortone Barbara, Trippella Giulia, Nicolini Giangiacomo, Lo Vecchio Andrea, Giannattasio Antonietta, Musso Paola, Serrano Elena, Marchisio Paola, Donà Daniele, Garazzino Silvia, Pierantoni Luca, Mazzone Teresa, Bernaschi Paola, Ferrari Alessandra, Gattinara Guido Castelli, Galli Luisa, Villani Alberto
Abstract
Abstract
Background
Acute hematogenous osteomyelitis (AHOM) is an insidious infection of the bone that more frequently affects young males. The etiology, mainly bacterial, is often related to the patient’s age, but it is frequently missed, owing to the low sensitivity of microbiological cultures. Thus, the evaluation of inflammatory biomarkers and imaging usually guide the diagnosis and follow-up of the infection. The antibiotic treatment of uncomplicated AHOM, on the other hand, heavily relies upon the clinician experience, given the current lack of national guidelines for the management of this infection.
Methods
A systematic review of the studies on the empirical treatment of uncomplicated AHOM in children published in English or Italian between January 1, 2009, and March 31, 2020, indexed on Pubmed or Embase search engines, was carried out. All guidelines and studies reporting on non-bacterial or complicated or post-traumatic osteomyelitis affecting newborns or children older than 18 years or with comorbidities were excluded from the review. All other works were included in this study.
Results
Out of 4576 articles, 53 were included in the study. Data on different topics was gathered and outlined: bone penetration of antibiotics; choice of intravenous antibiotic therapy according to the isolated or suspected pathogen; choice of oral antibiotic therapy; length of treatment and switch to oral therapy; surgical treatment.
Conclusions
The therapeutic management of osteomyelitis is still object of controversy. This study reports the first Italian consensus on the management of uncomplicated AHOM in children of pediatric osteomyelitis, based on expert opinions and a vast literature review.
Publisher
Springer Science and Business Media LLC
Cited by
9 articles.
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1. Musculoskeletal infections in childhood: Recognize early to quickly and properly treat;Global Pediatrics;2024-03 2. Appropriate Antibiotic Duration in Pediatric Bone and Joint Infection: A Systematic Review;Journal of the Pediatric Orthopaedic Society of North America;2023-11 3. Surveillance of osteoarticular infections caused by Staphylococcus aureus in a paediatric hospital in Mexico City;Frontiers in Cellular and Infection Microbiology;2022-12-08 4. New insights in pediatrics in 2021: choices in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine;Italian Journal of Pediatrics;2022-11-26 5. Risk Factors Affecting Development and Persistence of Preschool Wheezing: Consensus Document of the Emilia-Romagna Asthma (ERA) Study Group;Journal of Clinical Medicine;2022-11-04
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