Summary
- Latest clinical practice guidelines for acute bacterial arthritis (ABA) in children were reviewed at the 2024 Pediatric Academic Societies annual meeting.
- ABA is a bacterial infection of joint fluid with signs of infection and can be suspected, confirmed, or presumed.
- Diagnostic testing includes blood culture, CRP level, and CBC, with imaging recommended for proper diagnosis.
- Empirical antibiotic choices should cover S aureus and MRSA when local prevalence is high, with consideration for other bacteria based on age and symptoms.
- Response to therapy should be monitored using CRP levels, and treatment duration can range from 10-14 days without osteomyelitis to 21-28 days for complicated cases.
New Guidelines for Diagnosing and Treating Acute Bacterial arthritis in Children
Experts recently reviewed new guidelines for diagnosing and treating acute bacterial arthritis (ABA) in children at the Pediatric Academic Societies annual meeting. A multidisciplinary panel from the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America developed these guidelines.
ABA is a bacterial infection in a joint along with signs of infection. It can be suspected, confirmed, or presumed based on diagnostic testing. The most common bacteria causing ABA are Staphylococcus aureus and Kingella species. Streptococcus pneumoniae and Haemophilus influenzae are becoming less common causes.
To diagnose ABA, doctors recommend a combination of clinical history, exam, and laboratory testing. They suggest getting a blood culture before starting antibiotics because it can help limit unnecessary antibiotic use. Other tests like C-reactive protein levels and imaging studies can also be helpful in diagnosing ABA.
Treatment for ABA usually involves antibiotics that cover Staphylococcus aureus. In cases where MRSA is more common, specific antibiotics like clindamycin may be recommended. Additional testing and follow-up may be needed to ensure the infection is clearing up properly.
It’s essential for healthcare providers to follow these guidelines to ensure prompt and effective treatment for children with acute bacterial arthritis.
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Pediatrics, Infectious Diseases, Rheumatology