Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children.

Anti-Bacterial Agents / therapeutic use Child Drainage Drug Administration Schedule Humans Osteomyelitis / diagnosis Pediatrics Practice Guidelines as Topic
Antibiotic therapy Bone infections Children Paediatric infectious diseases Paediatric osteomyelitis Paediatrics

Journal

Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759

Informations de publication

Date de publication:
28 Aug 2021
Historique:
received: 06 08 2021
accepted: 11 08 2021
entrez: 29 8 2021
pubmed: 30 8 2021
medline: 31 12 2021
Statut: epublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

DOI: 10.1186/s13052-021-01130-4 PMID: 34454557 PMC: PMC8403408
pubmed: 34454557
doi: 10.1186/s13052-021-01130-4
pii: 10.1186/s13052-021-01130-4
pmc: PMC8403408
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

179

Informations de copyright

© 2021. The Author(s).

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Auteurs

Andrzej Krzysztofiak (A)

Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. andrzej.krzysztofiak@opbg.net.
ORCID: 0000-0002-9615-3671

Elena Chiappini (E)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Elisabetta Venturini (E)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Livia Gargiullo (L)

Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Marco Roversi (M)

Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Carlotta Montagnani (C)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Elena Bozzola (E)

Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Sara Chiurchiu (S)

Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Davide Vecchio (D)

Rare Disease and Medical Genetics, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Rome, Italy.

Elio Castagnola (E)

Infectious Disease Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.

Paolo Tomà (P)

Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Gian Maria Rossolini (GM)

Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

Renato Maria Toniolo (RM)

Surgery Department, Traumatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Susanna Esposito (S)

Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy.

Marco Cirillo (M)

Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Fabio Cardinale (F)

Department of Pediatrics and Emergency, Pediatric Allergy and Pulmunology Unit, Azienda Ospedaliera-Universitaria "Consorziale-Policlinico", Ospedale Pediatrico Giovanni XXIII, Bari, Italy.

Andrea Novelli (A)

Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy.

Giovanni Beltrami (G)

Department of Orthopaedic Oncology and Reconstructive Surgery, AOU Careggi, Florence, Italy.

Claudia Tagliabue (C)

Pediatric Highly Intensive Care Unit, Fondazione Ca' Granda Ospedale Maggiore Policlinico, IRCCS, Milan, Italy.

Silvio Boero (S)

Department of Pediatric Orthopaedics, IRCCS Istituto 'Giannina Gaslini', Children's Hospital, Genova, Italy.

Daniele Deriu (D)

Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Sonia Bianchini (S)

Department of Pediatrics, ASST Santi Paolo e Carlo Hospital, Milan, Italy.

Annalisa Grandin (A)

Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Samantha Bosis (S)

Pediatric Highly Intensive Care Unit, Fondazione Ca' Granda Ospedale Maggiore Policlinico, IRCCS, Milan, Italy.

Martina Ciarcià (M)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Daniele Ciofi (D)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Chiara Tersigni (C)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Barbara Bortone (B)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Giulia Trippella (G)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Giangiacomo Nicolini (G)

Pediatric Unit, San Martino Hospital, Belluno, Italy.

Andrea Lo Vecchio (A)

Section of Paediatrics, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.

Antonietta Giannattasio (A)

Pediatric Emergecy Department, AORN Santobono-Pausilipon, Naples, Italy.

Paola Musso (P)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Elena Serrano (E)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Paola Marchisio (P)

Pediatric Highly Intensive Care Unit, Fondazione Ca' Granda Ospedale Maggiore Policlinico, IRCCS, Milan, Italy.

Daniele Donà (D)

Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, Padua, Italy.

Silvia Garazzino (S)

Pediatric Infectious Disease Unit, Regina Margherita Children's Hospital, University of Turin, Turin, Italy.

Luca Pierantoni (L)

Pediatric Emergency Unit, Policlinico di Sant'Orsola, Bologna, Italy.

Teresa Mazzone (T)

, Rome, Italy.

Paola Bernaschi (P)

Microbiology Unit, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy.

Alessandra Ferrari (A)

Pediatric Unit, Cremona, Italy.

Guido Castelli Gattinara (GC)

Child and Adolescent Health Institute, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Luisa Galli (L)

Paediatric Infectious Disease Unit, Anna Meyer Children's University Hospital, Florence, Italy.

Alberto Villani (A)

Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Italian consensus on the therapeutic...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Italian consensus on the therapeutic...
questionsmedicales.fr › Procédures de chirurgie opératoire › Drainage › Italian consensus on the therapeutic...
questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Calendrier d'administration des médicaments › Italian consensus on the therapeutic...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Italian consensus on the therapeutic...
questionsmedicales.fr › Maladies ostéomusculaires › Maladies osseuses › Infections osseuses › Ostéomyélite › Italian consensus on the therapeutic...
questionsmedicales.fr › Professions de santé › Médecine › Pédiatrie › Italian consensus on the therapeutic...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Assurance de la qualité des soins de santé › Recommandations comme sujet › Guides de bonnes pratiques cliniques comme sujet › Italian consensus on the therapeutic...