Antibiotics in the Treatment of Acute Osteomyelitis and Acute Septic Arthritis in Children

A bacteriological survey of 101 patients with acute haematogenous osteomyelitis and of 45 patients with acute septic arthritis has been performed. In the osteomyelitis survey, the organism most frequently detected was Staphylococcus aureus (75% of cases). In 10% of cases streptococci were found. Staph. aureus was also the most frequently grown organism in cases of acute septic arthritis (48·5% of cases), but Haemophilus influenzae accounted for 34% of positive cultures. On the basis of the survey, a combination of methicillin or cloxacillin and penicillin is recommended for acute haematogenous osteomyelitis and methicillin or cloxacillin and ampicillin for acute septic arthritis. The best choice of antibiotics is vitally important since treatment has to commence before the results of culture are known. Repeated evaluation of trends In the pattern of organisms causing these diseases Is strongly recommended.