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October 1984

Oral Dicloxacillin for the Treatment of Neonatal Osteomyelitis

Author Affiliations

Department of Pediatrics Tripler Army Medical Center Honolulu, HI 96859

Am J Dis Child. 1984;138(10):991. doi:10.1001/archpedi.1984.02140480093033

Sir.—Recent reports advocate treating bone and joint infections with oral antibiotics after an initial course of intravenous (IV) therapy.1-5 This mode of therapy has not been recommended for newborns because of lack of information on the reliability of absorption of orally administered antibiotics in this age group.6

Satisfactory clinical response has been reported in five newborns with acute osteomyelitis treated in this manner; however, monitoring of peak and trough killing titers achieved in the infants' blood against the causative organism, as is recommended by most authorities, was not performed.7

Report of a Case.—We recently treated a 2,780-g term neonate with osteomyelitis. This male infant was delivered by emergency cesarean section because of fetal distress. A large amount of meconium was aspirated from his trachea immediately after delivery. His Apgar scores were 2 and 6 at one and five minutes, respectively. The baby subsequently manifested persistent

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