Review of Pediatric Osteoarticular Infections

Background: Pediatric osteoarticular infections are relatively rare but important diseases to identify early and treat appropriately in order to avoid associated acute complications or long-term morbidity. Objective: To review the current epidemiology and etiology of pediatric osteoarticular infections as well as recent advances in the diagnosis and treatment of these infections. Methods: We searched PubMed (MEDLINE) and Scopus databases for potentially relevant publications in the past 5 years. Results: Bacterial epidemiology and antimicrobial resistance profiles vary greatly worldwide, although Staphylococcus aureus, streptococci and Kingella kingae are the predominant pathogens. There is emerging evidence supporting the role of PCR assays for pathogen detection. Conclusion: Current data suggest that most children with osteoarticular infections can be successfully transitioned to oral antibiotics after having received at least several days of intravenous therapy, undergone removal of significant infectious foci and having demonstrated clinical improvement with down trending inflammatory markers. The optimal length and route of antimicrobial therapy have not been fully elucidated and should depend on individual patient factors, the virulence of the pathogen and the monitored clinical and laboratory response to therapy.