Chronic Osteomyelitis Mimicking Metastatic Disease

Abstract

antibiotic (no treatment-control) (1:1:1:1). Antibiotics were commenced 8—10 hours after enrollment. Patients were assessed in 24-hour intervals over 6 days. Results: In the intent-to-treat analysis, Campylobacter eradication was achieved in 20/30 controls and in all antibiotic-treated patients. Incidence of clinical cure during the observed period was 15/30 in the control, 14/30 in the erythromycin, 20/30 in the lower and 25/30 in the higher azithromycin dose group. With adjustment for age, sex, baseline symptom score and disease duration before enrollment, only azithromycin 30mg/kg was superior to no treatment: incidence ratio (IR) = 1.76 (95% CI 1.11—2.87). It was also superior to erythromycin (IR = 1.80, 97.5% CI 1.13—2.84). Regarding time to clinical cure, only azithromycin 30mg/kg was superior to no treatment: adjusted hazard ratio (HR = 3.80, 95% CI 1.97—7.32). It was also superior to erythromycin (HR = 4.17, 97.5% CI 1.91—9.09). All antibiotics improved (p < 0.05) symptom score reduction over time, most prominently azithromycin 30mg/kg, which was also superior to erythromycin (p < 0.001). All treatments were well tolerated. Conclusion: Single azithromycin 30mg/kg administration early after disease onset effectively eradicates the pathogen and accelerates clinical cure in childhood Campylobacter enterocolitis. It is clinically superior to an early commenced 5-day erythromycin regimen.