NEW ORLEANS — Antibiotic pretreatment in pediatric patients with hematogenous infections did not reduce surgical culture yield, according to results presented here.
“In pediatric patients who present with suspected osteoarticular infections, they should probably receive systemic antibiotics after blood culture has been obtained because delaying antibiotics to facilitate a greater culture yield appears to be unwarranted,” Michael Van Der Merwe, MBCHB, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Van Der Merwe and colleagues assigned 131 pediatric patients with acute hematogenous osteoarticular infections to receive antibiotics either before surgery (n=107) or after surgery (n=24).
“Our infection results revealed the pretreatment group had a higher [C-reactive protein] CRP on presentation at 190 vs. 127,” Van Der Merwe said.
He noted no significant differences between the groups for white blood cell count, erythrocyte sedimentation rate or infection multifocality, as well as no significant differences in admission duration or number of operative interventions.
“Our infection results also revealed that, in patients who were pretreated with antibiotics, there was no significant difference in the duration of their pretreatment and the development of positive or negative tissue cultures, with 46 hours being the mean duration of those who developed positive tissue cultures and 48 hours in those who developed negative tissue cultures,” Van Der Merwe said.
Administration of systemic antibiotics prior to receiving surgical cultures had no clinically significant effect on culture yield, according to culture unit outcomes. Van Der Merwe noted rates of positive tissue synovial fluid cultures of 85% and 54% in the pretreated and post-treated groups, respectively.
“We then conducted a multivariate analysis due to the CRP differences at baseline between both groups and this revealed that CRP independently correlates with surgical culture yield positivity, longer hospital admissions and increased number of surgical events,” Van Der Merwe said. – by Casey Tingle
Van Der Merwe M, et al. Paper #580. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 6-10, 2018; New Orleans.
Disclosure: Van Der Merwe reports no relevant financial disclosures.