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Managing bone and joint infection in children
  1. Saul N Faust1,2,
  2. Julia Clark3,
  3. Ann Pallett4,
  4. Nicholas M P Clarke5
  1. 1Clinical and Experimental Sciences, University of Southampton, Southampton, UK
  2. 2NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  3. 3Paediatric Immunology and Infectious Diseases, Newcastle upon Tyne Hospitals NHS Trust, Newcastle, UK
  4. 4Department of Microbiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  5. 5Department of Paediatric Orthopaedics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Saul N Faust, NIHR Wellcome Trust Clinical Research Facility, West Wing, Mailpoint 218, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK; s.faust{at}soton.ac.uk

Abstract

There is little high quality evidence on which to base the management of bone and joint infections in children. This pragmatic practice note aims to provide a consensus framework of best current practice prior to the availability of data from large national randomised controlled trials. For straightforward infection in previously normal children, recent trends suggest that shorter length of intravenous therapy with switch to oral treatment is acceptable, although this is not the case for the management of complex infections including those with multifocal disease, significant bone destruction, resistant or unusual pathogens, sepsis or in immunosuppressed children. Flowsheets for management based on the evidence reviewed are presented.

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Footnotes

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.