Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol
Tóm tắt
Pediatric osteomyelitis is a bacterial infection of bones requiring prolonged antibiotic treatment using parenteral followed by enteral agents. Major complications of pediatric osteomyelitis include transition to chronic osteomyelitis, formation of subperiosteal abscesses, extension of infection into the joint, and permanent bony deformity or limb shortening. Historically, osteomyelitis has been treated with long durations of antibiotics to avoid these complications. However, with improvements in management and antibiotic treatment, standard of care is moving towards short durations of intravenous antibiotics prior to enteral antibiotics. The authors will perform a systematic review based on PRISMA guidelines in order to evaluate the literature, looking for evidence to support the optimal duration of parenteral and enteral therapy. The main goals are to see if literature supports shorter durations of either parenteral antibiotics and/or enteral antibiotics. Multiple databases will be investigated using a thorough search strategy. Databases include Medline, Cochrane, EMBASE, SCOPUS, Dissertation Abstracts, CINAHL, Web of Science, African Index Medicus and LILACS. Search stream will include medical subject heading for pediatric patients with osteomyelitis and antibiotic therapy. We will search for published or unpublished randomized and quasi-randomized controlled trials. Two authors will independently select articles, extract data and assess risk of bias by standard Cochrane methodologies. We will analyze comparisons between dichotomous outcomes using risk ratios and continuous outcomes using mean differences. 95% confidence intervals will be computed. One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Our study aims to review the currently available evidence from randomized trials regarding duration of both parenteral and oral therapy for pediatric acute osteomyelitis.
CRD42013002320
Tài liệu tham khảo
Blyth MJR, Kincaid R, Craigen M, Bennet G: The changing epidemiology of acute and subacute haematogenous osteomyelitis in children. J Bone Joint Surg (Br). 2001, 83: 99-102. 10.1302/0301-620X.83B1.10699.
Craigen M, Watters J, Hackett JS: The changing epidemiology of osteomyelitis in children. J Bone Joint Surg (Br). 1992, 748: 541-545.
Dahl LB, Hoyland AL, Dramsdahl H, Kaaresen PI: Acute osteomyelitis in children: a population-based retrospective study 1965 to 1994. Scand J Infect Dis. 1998, 30: 573-577. 10.1080/00365549850161124.
Kenney WE: The prognosis in acute haematogenous osteomyelitis with and without chemotherapy. Surgery. 1944, 16: 477-484.
Ibingira CB: Chronic Osteomyelitis in a Ugandan Rural Setting. East Afr Med J. 2003, 80: 242-246.
Stanley CM, Rutherford GW, Morshed S, Coughlin RR, Beyeza T: Estimating the healthcare burden of Osteomyelitis in Uganda. Trans R Soc Trop Med Hyg. 2010, 104: 139-142. 10.1016/j.trstmh.2009.05.014.
Peltola H, Paakkonen M, Kallio P, Kallio MJ: Short versus long-term antimicrobial treatment for acute hematogenous osteomyelitis of childhood: prospective, randomized trial on 131 culture-positive cases. Pediatr Infect Dis J. 2010, 29: 1123-1128. 10.1097/INF.0b013e3181f55a89.
Paakkonen M, Peltola H: Antibiotic treatment for acute hematogenous osteomyelitis of childhood: moving towards shorter courses and oral administration. Int J Antimicrob Agents. 2011, 38: 273-280. 10.1016/j.ijantimicag.2011.04.007.
Anderson J, Scobie W, Watt B: The treatment of acute osteomyelitis in children: A 10-year experience. J Antimicrob Chemo. 1981, 7: 43-50. 10.1093/jac/7.suppl_A.43.
Asmar B: Osteomyelitis in the Neonate. Ped Infect. 1992, 6: 117-131.
Crary S, Buchannan GR, Drake CE: Venous Thrombosis and thromboembolism in children with osteomyelitis. J Paediatr. 2006, 149: 537-541. 10.1016/j.jpeds.2006.06.067.
Gutierrez K: Bone and joint infections in children. Pediatr Clin North Am. 2005, 52: 779-794. 10.1016/j.pcl.2005.02.005.
Harik NS, Smeltzer MS: Management of acute osteomyelitis in children. Expert Rev Anti-Infect Ther. 2010, 8: 175-181. 10.1586/eri.09.130.
Gutierrez KM: Osteomyelitis. Long: Principles and practice of pediatric infectious diseases. Edited by: Long SS, Pickering LK, Prober CG. 2012, Edinburgh: Churchill Livingstone, Elsevier Inc, chapter 78, 4
Kaplan SL: Osteomyelitis. Nelson Textbook of Pediatrics. Edited by: Kliegman RM, Stanton BF, Schor NF, St Geme JW, Behrman RE. 2011, Philadelphia: Saunders, 2394-2398. 19
Ruebner R, Keren R, Coffin S, Chu J, Horn D, Zaoutis TE: Complications of central venous catheters used for the treatment of acute hematogenous osteomyelitis. Pediatrics. 2006, 117: 1210-1215. 10.1542/peds.2005-1465.
Le Saux N, Howard A, Barrowman NJ, Gaboury I, Sampson M, Moher D: Shorter courses of parenteral antibiotic therapy do not appear to influenze response rates for children with acute hematogenous osteomyelitis: a systematic review. BMC Infect Dis. 2002, 14: 16-
Dartnell J, Ramachandran M, Katchburian M: Haematogenous acute and subacute paediatric osteomyelitis: a systematic review of the literature. J Bone Joint Surg Br. 2012, 94: 584-595. 10.2106/JBJS.J.01073.
Blockey NJ, Watson JT: Acute osteomyelitis in children. J Bone Joint Surg (Br). 1970, 52: 77-87.