Systematic review and meta-analysis finds antibiotic pretreatment does not decrease culture yield in pediatric osteoarticular infection, suggesting empiric therapy should not be withheld.
Key messageIn this systematic review and metaanalysis of 9 studies comprising 1,704 tissue culture specimens from children with osteoarticular infection, antibiotic pretreatment was not associated with reduced tissue culture yield (odds ratio, 1.60; 95% confidence interval, 1.23-2.08).Empiric anti biotic therapy should not be withheld to preserve culture yield in suspected osteoarticular infection; invasive cul tures should be obtained at the earliest safe opportunity without delaying treatment.
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Shieb et al. (2026) studied this question.
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