Spectrum: Local Antimicrobial Stewardship, for UCLA Health

Osteomyelitis - Improvement

Improvement with Negative Cultures

Change to oral Cephalexin 100-150mg/kg/day divided Q8h

1 month supply

Improvement with Positive Cultures

Targeted therapy

Antibiotics should be targeted towards the most likely pathogen or cultures

Duration: 4 weeks

Ultimate duration of therapy is determined by ID based on clinical improvement and laboratory evaluation

Continue treatment with IV antibiotics until patient is:

  • Improving clinically (decreased pain, afebrile)

  • Normalization of WBC

  • Appropriately down-trending CRP

Transition to oral if susceptible and no evidence of prolonged bacteremia per ID reccs

Consider Discharge

Discharge Criteria

  • CRP downtrending by ~ 50%

  • Afebrile 24 hours

  • Clinically improved

  • Resolved pain

  • Negative blood cultures x 48 hours

  • Cleared by physical therapy

  • Arrange home antibiotics if needed

Prior to d/c obtain ESR & CBC

Outpatient Follow-up

Follow up within 1 week of discharge with repeat ESR/CRP

  • Pediatric ID

  • Pediatric Orthopaedics