Novembre 2010 - Volume XXIX - numero 9

Medico e Bambino


Farmacoriflessioni

Trattamento antibiotico di osteomielite, artrite settica
e piomiosite

Federico Marchetti1, Elisa Rizzello1, Federico Poropat1, Francesca Rovere2, Claudio Germani3, Gianni Messi3, Sergio Demarini4, Marco Carbone5, Stefano Furlan6, Paolo Tamaro7, Marina Busetti8, Alessandro Ventura1

1Clinica Pediatrica, Dipartimento di Pediatria
2SC Farmacia e Nutrizione Parenterale
3SCO Pediatria d’urgenza con servizio di Pronto Soccorso
4SCO Neonatologia e Terapia Intensiva Neonatale
5SCO Ortopedia e Traumatologia
6SCO Anestesia e Rianimazione
7SCO Oncoematologia
8Servizio di Microbiologia e Medicina Preventiva, IRCCS “Burlo Garofolo”, Trieste

Indirizzo per corrispondenza: marchetti@burlo.trieste.it

ANTIBIOTIC TREATMENT FOR OSTEOMYELITIS, SEPTIC ARTHRITIS AND PYOMYOSITIS

Key words: Osteomyelitis, Septic arthritis, Pyomyositis, Audit, Antibiotic treatment, Children

Evidence for the choice or duration of antibiotic treatment for bone, joint infections and pyomyositis is scarce and no randomised trials (RCT) have been done in children and adolescents. The recommendations contained in this work come from the audit on the management of children with osteomyelitis, septic arthritis and pyomyositis hospitalized at the Institute for Child Health “Burlo Garofolo”, Trieste, Italy in the last 8 years. The antibiotic regimen should be based on likelihood of the organisms involved and current local sensitivity patterns, modified subsequently by results of Gram stain and culture. Because probable pathogen in all risk groups is Staphylococcus aureus, initial antibiotic treatment should have bactericidal activity against this bacterium. Suitable choices include β-lactamase-stable penicillins (such as oxacillin and similar) for the treatment of bone and joint infections (with the exception of newborns). For the cases of pyomyositis, findings of studies have consistently showed a worrying increase in meticillin-resistant Staphylococcus aureus infection and the choice of vancomicin or clindamycin seems to be reasonable. As to the duration of the treatment, 4 RCT on paediatric patients reported that the shorter courses of parenteral antibiotic therapy do not appear to influence response rates for children with acute hematogenous osteomyelitis.

Vuoi citare questo contributo?

F. Marchetti, E. Rizzello, F. Poropat, F. Rovere, C. Germani, G. Messi, S. Demarini, M. Carbone, S. Furlan, P. Tamaro, M. Busetti, A. Ventura Trattamento antibiotico di osteomielite, artrite settica
e piomiosite. Medico e Bambino 2010;29(9):585-589 https://www.medicoebambino.com/?id=1009_585.pdf


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