MODERN APPROACHES IN ANTIBACTERIAL THERAPY OF ACUTE HEMATOGENIC OSTEOMIELITIS IN CHILDREN

Abstract

Objective. Aim is to evaluate the effectiveness of antibiotic therapy used in acute hematogenous osteomyelitis (AHO) in children. Methods. From 2013 to 2016 years 64 patients with AHO were treated in the Department of Purulent Surgery of the Stavropol Regional Clinical Hospital, Russia. The children were divided into two groups: 1^st group received monotherapy (Daptomy-cin) with the subsequent transition to oral administration of Clindamycin; 2^nd group received standard antibacterial therapy (combination of Ceftriaxone and Amikacin with the subsequent transition to Cefotaxime). Clinical indices, laboratory parameters (leukocytes, ESR, CRP), pain syndrome (FPS-R) were assessed. Results. The duration of antibacterial therapy in 1^st group was 15.3±1.2 days. In 2^nd group the duration of therapy was 22.1±2.8 days. Normalization of leukocytes and ESR in children from 1^st group was on day 7, in contrast to group 2 where this index was normalized in 14 postoperative days. The long-lasting pain syndrome is associated with a large number of different injections in children of group 2, whereas in children of group 1, the pain syndrome was not on the 7^th day after the operation. Conclusions. The use of modern treatment approaches, including Daptomycin monotherapy followed by step-wise antibacterial therapy, reduced the treatment time for children with AHO and improved their quality of life.