PMID- 37757866
OWN - NLM
STAT- MEDLINE
DCOM- 20231030
LR  - 20231030
IS  - 2048-7207 (Electronic)
IS  - 2048-7193 (Linking)
VI  - 12
IP  - 10
DP  - 2023 Oct 28
TI  - Trimethoprim-Sulfamethoxazole for Pediatric Osteoarticular Infections.
PG  - 534-539
LID - 10.1093/jpids/piad076 [doi]
AB  - BACKGROUND: Trimethoprim-sulfamethoxazole (TMP-SMX) is active against most 
      Staphylococcus aureus isolates but is not widely used for the treatment of 
      pediatric osteoarticular infections. METHODS: This was a comparative 
      effectiveness study of hospitalized patients </=18 years treated with TMP-SMX vs. 
      other antibiotic regimens for acute osteoarticular infections between 2016 and 
      2021 at 3 hospitals using inverse probability of treatment weighted propensity 
      score analysis. The primary outcome was treatment failure, a composite of 
      unanticipated emergency department (ED) or outpatient visits, hospital 
      readmissions, extension, or change of antibiotic therapy due to inadequate 
      clinical response, or death, all within 6 months after completing antibiotics. 
      The secondary outcome was antibiotic-associated adverse events (AEs) within 6 
      months. The exposed group for the treatment failure analysis included children 
      who received >/=7 days of TMP-SMX and did not experience treatment failure while on 
      another antibiotic. Children receiving at least 1 dose of TMP-SMX were the 
      exposed group for the AE analysis. RESULTS: One-hundred and sixteen patients met 
      eligibility criteria; 26 (22.4%) patients were classified into the TMP-SMX cohort 
      and 90 (77.6%) into the other antibiotics cohort (most commonly clindamycin, 
      vancomycin, and cefazolin). There was no significant difference in treatment 
      failure between TMP-SMX and other antibiotics (43% vs. 19%; 95% CI .9-10.4). More 
      patients in the TMP-SMX cohort experienced an unplanned ED or outpatient visit 
      (OR 4.8, 95% CI 1.3-17.8). There was no difference in hospital readmission, 
      antibiotic change, or duration extension. Exposure to TMP-SMX was associated with 
      more AEs (41% vs. 19%, P = .012). CONCLUSIONS: Treatment with TMP-SMX was not 
      associated with greater clinical failure but was associated with more AEs 
      compared to alternative agents for the treatment of pediatric acute 
      osteoarticular infections.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of The 
      Journal of the Pediatric Infectious Diseases Society. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - McDaniel, Lauren M
AU  - McDaniel LM
AUID- ORCID: 0000-0002-5357-2817
AD  - Department of Pediatrics, University of Washington School of Medicine, Seattle 
      Children's Hospital, Seattle, Washington, USA.
FAU - Fiawoo, Suiyini
AU  - Fiawoo S
AD  - Department of Pediatrics, Johns Hopkins University School of Medicine, Johns 
      Hopkins Children's Center, Baltimore, Maryland, USA.
FAU - Tamma, Pranita D
AU  - Tamma PD
AD  - Department of Pediatrics, Johns Hopkins University School of Medicine, Johns 
      Hopkins Children's Center, Baltimore, Maryland, USA.
FAU - Same, Rebecca G
AU  - Same RG
AUID- ORCID: 0000-0003-0337-1168
AD  - Department of Pediatrics, Perelman School of Medicine at the University of 
      Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, 
      USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Pediatric Infect Dis Soc
JT  - Journal of the Pediatric Infectious Diseases Society
JID - 101586049
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
RN  - 0 (Anti-Bacterial Agents)
RN  - 3U02EL437C (Clindamycin)
SB  - IM
MH  - Humans
MH  - Child
MH  - *Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects
MH  - Retrospective Studies
MH  - Anti-Bacterial Agents/adverse effects
MH  - Clindamycin/adverse effects
MH  - *Staphylococcal Infections/drug therapy
OTO - NOTNLM
OT  - osteoarticular infection
OT  - osteomyelitis
OT  - septic arthritis
OT  - trimethoprim-sulfamethoxazole
EDAT- 2023/09/28 00:42
MHDA- 2023/10/30 06:46
CRDT- 2023/09/27 19:03
PHST- 2023/03/03 00:00 [received]
PHST- 2023/09/25 00:00 [accepted]
PHST- 2023/10/30 06:46 [medline]
PHST- 2023/09/28 00:42 [pubmed]
PHST- 2023/09/27 19:03 [entrez]
AID - 7284032 [pii]
AID - 10.1093/jpids/piad076 [doi]
PST - ppublish
SO  - J Pediatric Infect Dis Soc. 2023 Oct 28;12(10):534-539. doi: 
      10.1093/jpids/piad076.