Acute osteomyelitis due to Staphylococcus aureus in children: What is the status of treatment today?

Abstract

Osteomyelitis is an inflammatory process caused by microorganisms and usually accompanied by bone destruction. The process may be limited to one portion of the bone or spread to several areas such as the bone marrow, periosteum or cortex. 1 It is an infection that can occur at all ages. In children, the average age of onset is 6 years. Today, many of these risks factors are poorly understood or inadequately addressed in healthcare. If improperly treated, the infection can progress to chronicity , with possible recurrence several years after the acute episode. Staphylococcus aureus is the most frequently isolated pathogen. The treatment of acute osteomyelitis should be started at the earliest stage and initiated in hospital with intravenous antibiotics. The antibiotic molecules used must have good penetration in the bone and be bactericidal. The choice of the molecule for empirical treatment must take into account the local epidemiological features and results of bacteriological cultures. According to epidemiological data, the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) varies greatly from one country to another and from one continent to another. Overcrowding and low social-economic background are factors favouring the spread of MRSA in the community. Apart from ensuring early referral, the medical community also needs to do research on the main challenges facing us in the control of acute osteomyelitis, a disease that is especially serious in children, such as improved diagnosis, detection of drug resistance, shortened treatment regimens and clinical trials of new drugs.