Article in Japanese

Review of oral switch for treatment of osteomyelitis in children

Mihoko ISOGAI¹⁾, Saeko MORINO³⁾, Shintaro HIROTAKI¹⁾, Yoshihiko MORIKAWA²⁾, Kenta ITO¹⁾, Yuho HORIKOSHI¹⁾

The aim of this study was to evaluate the protocol on switching an antibiotic agent from parenteral therapy to oral therapy in suppurative osteomyelitis. This study included pediatric patients with osteomyelitis in Tokyo Metropolitan Children's Medical Center from March 2010 to December 2014. The protocol for switching to an oral agent is; 1) pain is resolved, 2) at least 2 weeks of parenteral antibiotic therapy is completed for patients with a positive blood culture, and 3) oral administration is feasible.
Total of 46 patients were identified with 25 (54%) and 21 (46%) having acute and chronic osteomyelitis respectively. The most affected bone was femur. Pathogens were identified in 26 patients (57%) of which 22 (81%) with positive cultures had methicillin-sensitive Staphylococcus aureus (MSSA). Blood cultures became positive in 48% of the patients. A total of 45 patients (98%) received oral antibiotic therapy following parenteral antibiotic therapy according to the switching protocol. Cephalexin was chosen for 82% of the patient cohort with no significant adverse effects or recurrence being observed.
The protocol of this study was successful in switching to an oral antibiotic agent without recurrence of suppurative osteomyelitis.

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1) Division of Infectious Diseases, Department of Pediatrics Tokyo Metropolitan
Children's Medical Center
2) Clinical Research Support Center, Department of Pediatrics Tokyo Metropolitan Children's Medical Center
3) National Institute of Infectious Diseases

Key words
Received	May 13, 2015
Accepted	November 11, 2015

27 (4)：297─303,2016