Benefits and risks of sequential parenteral-oral cephalosporin therapy for suppurative bone and joint infections

J. D. Nelson, R. W. Bucholz, H. Kusmiesz, S. Shelton

Research output: Contribution to journalArticle

62 Scopus citations

Abstract

Seventy-five infants and children with suppurative skeletal infections were managed with a sequential parenteral-oral regimen of cephalosporin antibiotic therapy. Initially, parenteral antibiotics (cefamandole for 48 patients and cefuroxime for 27 patients) were given for a median of 5 days. Oral therapy was with large doses of cefaclor (150 mg/kg/day) or cephalexin (100 mg/kg/day). Eight patients (11%) had inadequate serum bactericidal activity with cefaclor. Six of them were successfully managed with alternative oral antibiotics, and parenteral therapy resumed in 1 patient. Chronic disease developed in a child who was continued on oral cloxacillin therapy in spite of absent serum bactericidal activity. It is concluded that oral therapy can be successful for the majority of patients but that it is hazardous and not indicated if careful laboratory monitoring of compliance and serum bactericidal activity cannot be performed.

Original languageEnglish (US)
Pages (from-to)255-262
Number of pages8
JournalJournal of Pediatric Orthopaedics
Volume2
Issue number3
DOIs
StatePublished - Jan 1 1983

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

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