{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T04:37:28Z","timestamp":1772512648156,"version":"3.50.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T00:00:00Z","timestamp":1665014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012681","name":"Universit\u00e4tsklinikum K\u00f6ln","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012681","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>In recent years an earlier step down to oral antibiotic therapy has been advocated for numerous infections. Trained infectious disease specialists regularly consulting their colleagues may speed up the implementation of such recommendations into clinical practice and thus may improve treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively analyzed bone and joint infections in children admitted to the University Hospital of Cologne between 2010 and 2021. We assessed clinical, imaging, and microbiological findings and treatment modalities. Additionally, we assessed both the impact of a newly implemented pediatric infectious diseases consultation service and publications on revised treatment recommendations by comparing antibiotic therapy in two periods (2010\u20132016 versus 2017 to 2021).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 29 children presented with osteomyelitis, 16 with bacterial arthritis and 7 with discitis. In period 2 (2017\u20132021) we observed shorter duration of intravenous treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.009) and a higher percentage of oral antibiotic treatment in relation to the total duration of antibiotics (25% versus 59%, <jats:italic>p<\/jats:italic>\u2009=\u20090.007) compared to period 1 (2010\u20132016).<\/jats:p>\n                <jats:p>Yet, no differences were identified for the total length of antibiotic treatment. Additionally, biopsies or synovial fluid samples were retrieved and cultured in more children in period 2 (<jats:italic>p<\/jats:italic>\u2009=\u20090.077). The main pathogen identified in osteomyelitis and bacterial arthritis was Staphylococcus aureus (MSSA), diagnosis was confirmed predominantly with MRI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Recent guidelines addressing the safety of an earlier step-down (to oral) antibiotic therapy have influenced clinical practice in the treatment of bone and joint infections in our hospital. A newly implemented pediatric infectious diseases consultation service might have accelerated this progress resulting in a faster step down to oral treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s15010-022-01934-4","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T15:10:23Z","timestamp":1665069023000},"page":"831-838","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of a pediatric infectious disease consultation service on timely step-down to oral antibiotic treatment for bone and joint infections"],"prefix":"10.1007","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3052-2147","authenticated-orcid":false,"given":"Katrin","family":"Mehler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Oberth\u00fcr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1723-5995","authenticated-orcid":false,"given":"Ayla","family":"Yagdiran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4812-9220","authenticated-orcid":false,"given":"Sarina","family":"Butzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-0772","authenticated-orcid":false,"given":"Norma","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,10,6]]},"reference":[{"key":"1934_CR1","volume-title":"Bone and joint infections","author":"A Aarvold","year":"2021","unstructured":"Aarvold A, Sukhtankar P, Faust SN. Osteomyelitis in children. In: Zimmerli W, editor. Bone and joint infections. 2nd ed. Hoboken: Wiley-Blckwell; 2021.","edition":"2"},{"key":"1934_CR2","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1097\/INF.0b013e3181f55a89","volume":"29","author":"H Peltola","year":"2010","unstructured":"Peltola H, Paakkonen M, Kallio P, Kallio MJ, Osteomyelitis-Septic Arthritis Study G. Short- versus long-term antimicrobial treatment for acute hematogenous osteomyelitis of childhood: prospective, randomized trial on 131 culture-positive cases. Pediatr Infect Dis J. 2010;29:1123\u20138. https:\/\/doi.org\/10.1097\/INF.0b013e3181f55a89.","journal-title":"Pediatr Infect Dis J"},{"key":"1934_CR3","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1097\/BPO.0b013e3181b2b860","volume":"29","author":"RT Ballock","year":"2009","unstructured":"Ballock RT, Newton PO, Evans SJ, Estabrook M, Farnsworth CL, Bradley JS. A comparison of early versus late conversion from intravenous to oral therapy in the treatment of septic arthritis. J Pediatr Orthop. 2009;29:636\u201342. https:\/\/doi.org\/10.1097\/BPO.0b013e3181b2b860.","journal-title":"J Pediatr Orthop"},{"key":"1934_CR4","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1186\/s13052-021-01130-4","volume":"47","author":"A Krzysztofiak","year":"2021","unstructured":"Krzysztofiak A, Chiappini E, Venturini E, Gargiullo L, Roversi M, Montagnani C, et al. Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children. Ital J Pediatr. 2021;47:179. https:\/\/doi.org\/10.1186\/s13052-021-01130-4.","journal-title":"Ital J Pediatr"},{"key":"1934_CR5","doi-asserted-by":"publisher","first-page":"e139","DOI":"10.1016\/S1473-3099(16)30024-X","volume":"16","author":"BJ McMullan","year":"2016","unstructured":"McMullan BJ, Andresen D, Blyth CC, Avent ML, Bowen AC, Britton PN, et al. Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: systematic review and guidelines. Lancet Infect Dis. 2016;16:e139\u201352. https:\/\/doi.org\/10.1016\/S1473-3099(16)30024-X.","journal-title":"Lancet Infect Dis"},{"key":"1934_CR6","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1097\/INF.0000000000001635","volume":"36","author":"J Saavedra-Lozano","year":"2017","unstructured":"Saavedra-Lozano J, Falup-Pecurariu O, Faust SN, Girschick H, Hartwig N, Kaplan S, et al. Bone and Joint Infections. Pediatr Infect Dis J. 2017;36:788\u201399. https:\/\/doi.org\/10.1097\/INF.0000000000001635.","journal-title":"Pediatr Infect Dis J"},{"key":"1934_CR7","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1093\/jpids\/piab027","volume":"10","author":"CR Woods","year":"2021","unstructured":"Woods CR, Bradley JS, Chatterjee A, Copley LA, Robinson J, Kronman MP, et al. Clinical Practice Guideline by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America: 2021 Guideline on Diagnosis and Management of Acute Hematogenous Osteomyelitis in Pediatrics. J Pediatric Infect Dis Soc. 2021;10:801\u201344. https:\/\/doi.org\/10.1093\/jpids\/piab027.","journal-title":"J Pediatric Infect Dis Soc"},{"key":"1934_CR8","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1007\/s15010-016-0883-1","volume":"44","author":"S Rieg","year":"2016","unstructured":"Rieg S, Kupper MF. Infectious diseases consultations can make the difference: a brief review and a plea for more infectious diseases specialists in Germany. Infection. 2016;44:159\u201366. https:\/\/doi.org\/10.1007\/s15010-016-0883-1.","journal-title":"Infection"},{"key":"1934_CR9","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1186\/s12879-020-05550-1","volume":"20","author":"A Cona","year":"2020","unstructured":"Cona A, Gazzola L, Vigano O, Bini T, Marchetti GC, d\u2019Arminio MA. Impact of daily versus weekly service of infectious diseases consultation on hospital antimicrobial consumption: a retrospective study. BMC Infect Dis. 2020;20:812. https:\/\/doi.org\/10.1186\/s12879-020-05550-1.","journal-title":"BMC Infect Dis"},{"key":"1934_CR10","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1007\/s15010-012-0283-0","volume":"40","author":"A de La Blanchardiere","year":"2012","unstructured":"de La Blanchardiere A, Boutemy J, Thibon P, Michon J, Verdon R, Cattoir V. Clinical benefit of infectious diseases consultation: a monocentric prospective cohort study. Infection. 2012;40:501\u20137. https:\/\/doi.org\/10.1007\/s15010-012-0283-0.","journal-title":"Infection"},{"key":"1934_CR11","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/INF.0000000000000113","volume":"33","author":"A Gwee","year":"2014","unstructured":"Gwee A, Carapetis JR, Buttery J, Starr M, Connell TG, Steer A, et al. Formal infectious diseases consultations at a tertiary pediatric hospital: a 14-year review. Pediatr Infect Dis J. 2014;33:411\u20133. https:\/\/doi.org\/10.1097\/INF.0000000000000113.","journal-title":"Pediatr Infect Dis J"},{"key":"1934_CR12","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1007\/s15010-017-1009-0","volume":"45","author":"K Kreitmeyr","year":"2017","unstructured":"Kreitmeyr K, von Both U, Pecar A, Borde JP, Mikolajczyk R, Huebner J. Pediatric antibiotic stewardship: successful interventions to reduce broad-spectrum antibiotic use on general pediatric wards. Infection. 2017;45:493\u2013504. https:\/\/doi.org\/10.1007\/s15010-017-1009-0.","journal-title":"Infection"},{"key":"1934_CR13","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1097\/INF.0000000000003058","volume":"40","author":"K Kreitmeyr","year":"2021","unstructured":"Kreitmeyr K, Pecar A, Mikolajczyk R, von Both U, Huebner J. Pediatric antibiotic stewardship: optimization of vancomycin therapy based on individual pharmacokinetics. Pediatr Infect Dis J. 2021;40:556\u201362. https:\/\/doi.org\/10.1097\/INF.0000000000003058.","journal-title":"Pediatr Infect Dis J"},{"key":"1934_CR14","doi-asserted-by":"publisher","first-page":"70","DOI":"10.12788\/jhm.3538","volume":"16","author":"JM Cotter","year":"2021","unstructured":"Cotter JM, Hall M, Girdwood ST, Stephens JR, Markham JL, Gay JC, et al. Opportunities for stewardship in the transition from intravenous to enteral antibiotics in hospitalized pediatric patients. J Hosp Med. 2021;16:70\u20136. https:\/\/doi.org\/10.12788\/jhm.3538.","journal-title":"J Hosp Med"},{"key":"1934_CR15","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.amjmed.2021.10.007","volume":"135","author":"N Wald-Dickler","year":"2022","unstructured":"Wald-Dickler N, Holtom PD, Phillips MC, Centor RM, Lee RA, Baden R, et al. Oral Is the New IV. Challenging decades of blood and bone infection dogma: a systematic review. Am J Med. 2022;135:369-79 e1. https:\/\/doi.org\/10.1016\/j.amjmed.2021.10.007.","journal-title":"Am J Med"},{"key":"1934_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2022.04.005","author":"B Spellberg","year":"2022","unstructured":"Spellberg B, Rice LB. The Shorter Is Better movement: past, present, future. Clin Microbiol Infect. 2022. https:\/\/doi.org\/10.1016\/j.cmi.2022.04.005.","journal-title":"Clin Microbiol Infect"},{"key":"1934_CR17","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1086\/597582","volume":"48","author":"H Peltola","year":"2009","unstructured":"Peltola H, Paakkonen M, Kallio P, Kallio MJ, Osteomyelitis-Septic Arthritis Study G. Prospective, randomized trial of 10 days versus 30 days of antimicrobial treatment, including a short-term course of parenteral therapy, for childhood septic arthritis. Clin Infect Dis. 2009;48:1201\u201310. https:\/\/doi.org\/10.1086\/597582.","journal-title":"Clin Infect Dis"},{"issue":"10","key":"1934_CR18","doi-asserted-by":"publisher","first-page":"1792","DOI":"10.1111\/apa.14373","volume":"107","author":"R Alcobendas","year":"2018","unstructured":"Alcobendas R, Remesal A, Murias S, Nunez E, Calvo C. Outpatients with acute osteoarticular infections had favourable outcomes when they received just oral antibiotics without intravenous antibiotics. Acta Paediatr. 2018;107(10):1792\u20137. https:\/\/doi.org\/10.1111\/apa.14373.","journal-title":"Acta Paediatr"},{"key":"1934_CR19","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1093\/jpids\/piv009","volume":"4","author":"M Paakkonen","year":"2015","unstructured":"Paakkonen M, Kallio PE, Kallio MJ, Peltola H. Does bacteremia associated with bone and joint infections necessitate prolonged parenteral antimicrobial therapy? J Pediatric Infect Dis Soc. 2015;4:174\u20137. https:\/\/doi.org\/10.1093\/jpids\/piv009.","journal-title":"J Pediatric Infect Dis Soc"},{"key":"1934_CR20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2020-001120","author":"BJ McMullan","year":"2021","unstructured":"McMullan BJ, Mahony M, Java L, Mostaghim M, Plaister M, Wu C, et al. Improving intravenous-to-oral antibiotic switch in children: a team-based audit and implementation approach. BMJ Open Qual. 2021. https:\/\/doi.org\/10.1136\/bmjoq-2020-001120.","journal-title":"BMJ Open Qual."},{"key":"1934_CR21","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1093\/jpids\/pis108","volume":"2","author":"M Paakkonen","year":"2013","unstructured":"Paakkonen M, Kallio MJ, Kallio PE, Peltola H. Significance of negative cultures in the treatment of acute hematogenous bone and joint infections in children. J Pediatric Infect Dis Soc. 2013;2:119\u201325. https:\/\/doi.org\/10.1093\/jpids\/pis108.","journal-title":"J Pediatric Infect Dis Soc"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-022-01934-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-022-01934-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-022-01934-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T19:04:29Z","timestamp":1689620669000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-022-01934-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,6]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["1934"],"URL":"https:\/\/doi.org\/10.1007\/s15010-022-01934-4","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,6]]},"assertion":[{"value":"5 June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"NJ has received lecture fees from Gilead, Infectopharm, MSD, Bayer and Labor Stein and travel grants from Pfizer, Gilead, Basilea, Correvio, Pfizer and Novartis and grants from an observational study from Infectopharm. AO and KM have received lecture fees from AstraZeneca and Chiesi and travel grants from Gilead. AY and SB have no relevant financial or non-financial interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was waived by the local Ethics Committee of the University of Cologne in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}