Stresses in Pediatric Hospital Medicine

[摘要] One of the most difficult questions facing a hospitalist is when to transition to oral antibiotics. Osteoarticular infections continue to be one of the diagnoses that pit infectious disease (ID) , hospitalists, and surgeons against each other, with varying degrees of comfort with duration of oral versus intravenous antibiotics. A group out of Singapore has been using C-reactive proteins (CRPs) to help make the decision and have some exciting findings. 1#### The studyThis was a retrospective case series of all pediatric patients aged 6 weeks to 18 years admitted to the KK Women’s and Children’s Hospital from 2007 to 2013 with a diagnosis of osteoarticular infection. Intravenous antibiotics were used until clinical improvement was noted, and the CRP level decreased by half over a period of 4 days, at which time they switched to oral antibiotics. Patient follow-up was conducted via chart review for a period of 18 months to assess for complications.#### The key findingsA total of 37 patients were included, 24 with osteomyelitis only, 11 with septic arthritis only, and 2 with both. Of these, 34 patients transitioned to oral antibiotics after a 50% decline in CRP over 4 days. One of these patients developed complications (2.94%). The …

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob