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Comment & Response |

Sequential Intravenous Oral Antibiotic Therapy for Osteomyelitis How Short Is Long Enough?

Ian C. Michelow, MD, MMed, DTM&H1,2,3; Jason G. Mandell, MS, MD2,3
[+] Author Affiliations
1Division of Infectious Diseases, Rhode Island Hospital, Providence
2Warren Alpert Medical School of Brown University, Providence, Rhode Island
3Department of Pediatrics, Rhode Island Hospital, Providence
JAMA Pediatr. 2015;169(7):698-699. doi:10.1001/jamapediatrics.2015.0712.
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To the Editor The Keren et al article1 published in JAMA Pediatrics adds to the growing evidence that an early transition from intravenous to enteral antibiotics for acute hematogenous osteomyelitis in children is safe, effective, and protective against unavoidable morbidity ascribed to peripherally inserted central catheters. Their findings are consistent with 2 prospective studies in England and Australia2 as well as Finland3 in which the median duration of parenteral antibiotics in the sequential intravenous oral antibiotic arm was 4 days compared with 6 days in the current study. Nevertheless, we identified deficiencies in the authors’ statistical approach that may limit the generalizability of these findings.


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