Osteomyelitis accounts for up to 1% of pediatric hospitalizations in the US. Inadequate treatment leads to serious morbidity including chronic infection and permanent bone injury, with associated consequences for growth and function in children. Expert consensus had recommended 4 to 6 weeks of IV antibiotic treatment for acute osteomyelitis in children, which was costly and carried risks from long-term central venous catheters. Small case series and one systematic review suggested that sequential therapy, a short course of IV antibiotics followed by oral antibiotics, yielded equivalent outcomes to IV therapy alone, but this was the first study to directly compare these approaches.

To compare treatment outcomes in children who receive sequential therapy vs. prolonged IV antibiotics for acute osteomyelitis.

Retrospective, single-blinded cohort study in 29 US children’s hospitals from 2000 to 2005.