Abstract

Nine children with osteomyelitisand/or septic arthritis weretreated sequentially with parenteral sulbactam/ampicillin and oral sultamicillin. Causative pathogens were identified in six cases; all were susceptible to the combination of ampicillin and sulbactam. The mean duration of parenteral therapy was 7.1 days (6–11 days), and the average hospital stay was 10.3 days (6–18 days). Peak serum bactericidal titers of ⩾1:8 were achieved in all patients during parenteral therapy; only one child receiving oral therapy did not achieve a titer of ⩾1:4. At follow-up, all of the children were cured clinically and there was no evidence of relapse. Adverse reactions to oral therapy were minimal. The regimen of parenteral sulbactam/ampicillin and oral sultamicillin used sequentially is effective and safe for the treatment of skeletal infections in children. The use of this approach significantly reduced the duration of hospitalization.

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