Article ; Online: Trimethoprim-Sulfamethoxazole for Pediatric Osteoarticular Infections.
Journal of the Pediatric Infectious Diseases Society
2023 Volume 12, Issue 10, Page(s) 534–539
Abstract: 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 ... ...
Abstract | 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. |
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MeSH term(s) | Humans ; Child ; Trimethoprim, Sulfamethoxazole Drug Combination/adverse effects ; Retrospective Studies ; Anti-Bacterial Agents/adverse effects ; Clindamycin/adverse effects ; Staphylococcal Infections/drug therapy |
Chemical Substances | Trimethoprim, Sulfamethoxazole Drug Combination (8064-90-2) ; Anti-Bacterial Agents ; Clindamycin (3U02EL437C) |
Language | English |
Publishing date | 2023-09-22 |
Publishing country | England |
Document type | Journal Article |
ZDB-ID | 2668791-4 |
ISSN | 2048-7207 ; 2048-7193 |
ISSN (online) | 2048-7207 |
ISSN | 2048-7193 |
DOI | 10.1093/jpids/piad076 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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