Initial Oral Antibiotics for Bone and Joint Infections in Children: A Prospective Nationwide Real-world Effectiveness Study in Denmark
Initial oral antibiotic treatment for children and adolescents with uncomplicated bone and joint infections (BJI) has been found non-inferior to initial IV antibiotics in one randomized controlled trial (RCT). The real-world effectiveness of initial oral antibiotics for children and adolescents with BJI is unclear. This nationwide, prospective, multicenter, real-world cohort study aims to compare the effectiveness and safety of initial oral antibiotic treatment for children and adolescents with uncomplicated BJI in a real-world setting with those who received initial oral antibiotics in our RCT.
⁃ Children and adolescents aged 3 months to 17 years with uncomplicated bone and joint infections treated with initial oral antibiotics.
⁃ According to Danish Nationwide Guidelines (initiated in 2024), initial oral antibiotics are recommended to patients with no risk factors for complicated disease. Risk factors include for complicated disease include:
• Severe illness or sepsis
• Rapid symptom progression
• Pronounced symptoms, including severe pain
• Pronounced soft tissue involvement
• Foreign material or post-surgical infection
• Infection with a resistent or rare pathogen, e.g., Salmonella or MRSA
• Severe comorbidity, including immunodeficiency
⁃ Patients who have received intravenous antibiotic therapy for less than 24 h before oral antibiotics will be included