DETROIT Mich Thursday Jan 15 2015 After reviewing the histories of more than 2 000 American children who were treated with antibiotics for bone infections a national team of pediatric researchers has come up with a surprising finding that could change the way kids receive the drugs in the future The large study found that children who were discharged home with oral antibiotics did just as well in overcoming their bone infections as those who were sent home on intravenous antibiotics Said Childrens Hospital of Michigan Chief of Pediatric Hospital Medicine and Assistant Professor of Pediatrics for the Wayne State University School of Medicine Banu Kumar MD who led the Childrens Hospital of Michigan group participating in this study This very large clinical trial shows that oral antibiotics also cause significantly fewer complications and that there is no advantage of the more invasive prolonged intravenous therapy Based on these very hopeful findings clinicians who treat pediatric bone infections may want to reconsider prescribing intravenous delivery of antibiotics for patients who are being sent home for extended drug therapy Published last month in the Journal of the American Medical Association Pediatrics the results of the study http archpedijamanetworkcom articleaspx articleid 2022276 seem likely to challenge the long-held belief that intravenous-delivered antibiotics are more effective than pills in combating bone infections in children The analysis of medication records among 2 060 children at 36 US hospitals also found that 15 percent of the children who received antibiotics intravenously through a peripherally inserted central catheter developed complications that later sent them back to an emergency room or required rehospitalization The potentially significant implications of these findings were strongly underlined in an accompanying Journal editorial that noted that on the basis of the study Clinicians should strongly consider transition to oral antibiotic therapy at the time of discharge for the treatment of acute osteomyelitis in otherwise healthy children The study also noted that the gravity of the complications that can result from IV antibiotics delivery including bloodstream infection thromboembolism and line breakage warrants careful reassessment by clinicians of the longtime presumption that intravenous antibiotics are just as safe as the oral version At the Childrens Hospital of Michigan that participated in the groundbreaking study Dr Kumar said the results might eventually help to spare children with bone infections the discomfort and health risks that sometimes accompany intravenous delivery of antibiotics The typical course of treatment for these children is anywhere from six to 12 weeks Dr Kumar said and that means they have to live 24 7 with a peripherally inserted central catheter inserted into their arms It also means that their caregivers have to be trained to do the dosing two or three times a day often for several months Given the obvious discomfort anxiety and risk of infection that can be part of the intravenous procedures the possibility that we could get the same effectiveness from an orally delivered antibiotic is quite promising Based on these very hopeful findings clinicians who treat pediatric bone infections may want to reconsider prescribing intravenous delivery of antibiotics for patients who are being sent home for extended drug therapy Dr Kumar added that the findings are a compelling example of how good research can improve medical care A study like this gives us enormous hope because it shows how the clinicians and researchers at the Childrens Hospital of Michigan are constantly striving to make standard care more tolerable and safer for kids At the end of the day research is an important key to the best care We need more of these kinds of studies to show there are better ways to care for kids Children dont like to be poked and children dont like to be hurt and if there are things we can do more effectively more safely why not Steven E Lipshultz MD pediatrician-in-chief at the Childrens Hospital of Michigan and chair of Pediatrics for the Wayne State University School of Medicine said he was greatly encouraged by the study which has the potential to provide significant cost savings as well as improved care for pediatric patients Dr Kumar and the other researchers really hit it out of the park with this comparative effectiveness study Dr Lipshultz said Whats exciting for all of us at the Childrens Hospital of Michigan is to know that for the past three years or so weve been using this form of oral therapy for bone infections as part of the study which means that weve been providing better care for these patients Based on this study that has demonstrated that in the absence of data supporting that long-term intravenous antibiotics enhance clinical outcomes when compared with oral therapy our practice at the Childrens Hospital of Michigan of transitioning otherwise healthy children with acute osteomyelitis to oral antibiotic therapy at the time of discharge to avoid peripherally inserted central catheter-associated complications is both right for the patient and the right thing to do At the Childrens Hospital of Michigan were doing our best every single day to connect the very latest research to clinical care so that our patients can benefit as much as possible As Dr Kumar and her colleagues around the country have demonstrated in this important study children benefit most when their treatment is informed by the very latest cutting-edge research This is an example of how we use practice-based evidence to achieve the very best outcomes for our patients by implementing evidence-based practice