Clinical Epidemiology and Outcomes of Pediatric Musculoskele
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A Study was conducted to understand the epidemiology of acute hematogenous osteomyelitis (AHO) and septic arthritis (SA), including clinical and demographic features, microbiology, treatment approaches, treatment-associated complications, and outcomes.

Analysis included 453 children with AHO and/or SA from.

Results:
--Among the 453 patients, 218 had AHO, 132 had SA, and 103 had concurrent AHO/SA.

--Treatment failure/recurrent infection occurred in 41.

--Patients with concurrent AHO/SA had longer hospital stays, longer duration of antibiotic therapy, and were more likely to have prolonged bacteremia and require intensive care.

--Staphylococcus aureus was identified in 228 of patients, of which 114 were methicillin-resistant S. aureus (MRSA).

--Compared with SA, AHO and concurrent AHO/SA were associated with higher odds of treatment failure (OR 8.19 and OR 14.43).

--Need for more than one surgical procedure was also associated with higher odds of treatment failure.

--Early change to oral antibiotic therapy was not associated with treatment failure (OR 0.64). Most (73%) medically-attended treatment complications occurred while on parenteral therapy.

To summarize, musculoskeletal infections are difficult to treat in children. The most prevalent pathogen is still S. aureus, with MRSA responsible for 25% of all cases. Concurrent AHO/SA is linked to a worsening of the condition and worse outcomes. When on oral therapy, there were less treatment-related complications. Treatment failure was not linked to switching to oral therapy early.

Source: https://www.jpeds.com/article/S0022-3476(21)00266-3/fulltext?rss=yes
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