Leanna Barker, PGY1

Children's of Alabama, Birmingham, Alabama

Objectives: 

1. Discuss the pathophysiology of acute and chronic osteomyelitis
2. Discuss the importance of appropriate antimicrobial selection and dosing in pediatric osteomyelitis
3. Evaluate the role of early ID consultation in the management of pediatric osteomyelitis

Abstract:

Introduction
Acute pediatric osteomyelitis is a common disease that affects previously healthy children of all ages. Hematogenous spread is the most common source of infection and it typically affects the long bones, such as the tibia and femur. In many cases, a causative organism is never identified despite culture attempts. The most common organisms that have been identified are Staphylococcus aureus, Streptococcus pyogenes, and Kingella kingae. Despite the increased prevalence, there are still several questions around the management of these patients. The optimization of antimicrobial therapy is crucial to the prevention of chronic osteomyelitis. Infectious disease (ID) involvement and antimicrobial stewardship programs can play a vital role in the management of pediatric osteomyelitis patients. Potential roles include creating clinical pathways, guidance with antibiotic choice and dosing, and recommendations for duration of therapy.

Methods
This study is a retrospective chart review of patients treated at Children’s of Alabama (COA) with a diagnosis of acute and/or chronic osteomyelitis. Patients were identified by ICD-10 codes from both inpatient and outpatient visits over the past 24 months. ICD-10 codes include M86 and M86.6. The primary objective of this study is to evaluate the current medical management of acute osteomyelitis at COA and whether early consultation with a pediatric ID specialist effects patient outcomes. Patients who had a pediatric ID consultation on their initial hospitalization at time of diagnosis of acute osteomyelitis will be compared to those who did not. The outcomes to be evaluated include antibiotic selection, dose and duration of therapy for both intravenous and oral antimicrobials, length of hospitalization, and rates of readmission and complications. Patients with spina bifida or chronic recurrent multifocal osteomyelitis were excluded.

Results
Results will be submitted within final slides.

Conclusion
Conclusion will be submitted within final slides.

Handout Slides:

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