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Author Notes:

alansell22@gmail.com

AL conceptualized and designed the study, designed the data collection instruments, collected data, carried out the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript. YV collected data, carried out the initial analysis, drafted the initial manuscript, and reviewed and revised the manuscript. PS contributed to the design of the study, assisted in the initial analysis and interpretation of data, and critically reviewed the manuscript for important intellectual content. JF designed the data collection instruments, carried out the analyses, and critically reviewed the manuscript for important intellectual content. AK conceptualized and designed the study, collected data, carried out the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript. All authors have read and approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

We thank Chelsea J. Marion, MD and Andrew McReynolds, MD for their assistance with chart review.

The authors declare that they have no competing interests.

Subjects:

Research Funding:

No external funding was secured for this project or manuscript.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • Child
  • Hospitalized
  • Arthritis
  • Infectious
  • Osteomyelitis
  • Anti-bacterial agents
  • Retrospective studies
  • ACUTE HEMATOGENOUS OSTEOMYELITIS
  • PEDIATRIC OSTEOMYELITIS
  • MANAGEMENT

Impact of antibiotic pretreatment on cultures in children with osteomyelitis and septic arthritis: a retrospective review

Tools:

Journal Title:

BMC PEDIATRICS

Volume:

Volume 21, Number 1

Publisher:

, Pages 342-342

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: In the management of pediatric osteomyelitis or septic arthritis, delay in treatment may affect outcome, while receipt of antibiotics prior to culture may affect culture results. We aimed to determine if pathogen identification decreased in cultures that were pretreated with antibiotics. Methods: We conducted a retrospective cohort study of 584 hospitalized children between 30 days and 18 years of age admitted to two tertiary children’s hospitals. Logistic regression assessed the effect of antibiotic duration on blood, bone, joint aspirate, and “other” culture positivity. Results: Overall, 42% of blood cultures, 70% of bone cultures, 39% of joint cultures, and 70% of “other” cultures were positive. Compared with children who did not receive antibiotics prior to culture, there were no significant differences in odds of a positive culture in children whose cultures were pretreated with antibiotics for any of the culture types [OR (95% CI) 0.90 (0.56–1.44) for blood cultures, 0.77 (0.25–2.34) for bone cultures, 0.71 (0.39–1.28) for joint cultures, 1.18 (0.58–2.41) “for other” cultures; all p > 0.05]. Furthermore, the duration (hours) of antibiotics in the pretreated cultures was also not a significant predictor of culture positivity (OR ranged from 0.99–1.00 for all cultures, p > 0.05). Conclusions: Culture positivity was not associated with antibiotic pretreatment in any of the samples, even for longer duration of antibiotics prior to culture, though the small sample size of subgroups is an important limitation. In pediatric patients hospitalized with osteomyelitis and/or septic arthritis, early initiation of antibiotics may not affect culture positivity.

Copyright information:

© The Author(s) 2021

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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