The ability to provide long-term antibiotic therapy for acute osteomyelitis was revolutionized by the use of peripherally inserted central catheters (PICCs). Peripherally inserted central catheters provided an alternative for children to receive antibiotic therapy outside the health care setting, which reduced their hospital length of stay and improved their quality of life. However, PICCs can be complicated by infectious and noninfectious sequelae.1 Clinicians must weigh the risks of intravenous (IV) therapy against the risk for treatment failure when considering a change from IV to oral therapy in children with acute osteomyelitis. In this issue of JAMA Pediatrics, Keren and colleagues2 suggest that in otherwise healthy children, we may be able to convert therapy from IV antibiotics to oral agents early in the treatment course without compromising clinical outcomes, thereby avoiding the long-term use of PICCs.
Tamma PD, Milstone AM. Outpatient Antibiotic Therapy for Acute Osteomyelitis in ChildrenBalancing Safety and Efficacy. JAMA Pediatr. 2015;169(2):108-109. doi:10.1001/jamapediatrics.2014.2850