ABSTRACT Aim To evaluate clinical features, management, and outcomes of paediatric bone and joint infection (BJI) in a regional Australian hospital and assess weight‐based oral antibiotic prescribing. Methods We conducted a retrospective study of 171 children aged 0–18 years admitted with septic arthritis and/or osteomyelitis between 2011 and 2021. Cases were identified using ICD‐10‐AM codes, and data on clinical presentation, microbiology and treatment were extracted from medical records. Oral antibiotic doses were assessed against international evidence‐based guidelines. Results A total of 171 children were included (median age 27 months); 59.6% were aged ≤ 5 years, and 13.5% identified as Aboriginal or Torres Strait Islander. Staphylococcus aureus was the most frequently identified pathogen overall (53/108, 49.1%), and Kingella kingae in children < 5 years of age (20/57, 35.1%). Severe disease occurred in 29.8%. Oral antibiotic doses were below international guideline recommendations in 43.3% of cases, mostly with amoxicillin–clavulanate and cephalexin. Relapse (4.1%) and long‐term sequelae (6.1%) were infrequent. Conclusions Paediatric BJI mostly occurred in young and in Aboriginal and Torres Strait Islander children. Oral antibiotic weight‐based dosing was often lower than international guideline recommendations for BJI. These findings highlight the need for standardised antibiotic dosing in BJI and further studies to optimise dosing in children.
Johnston et al. (Thu,) studied this question.