Abstract | BACKGROUND: ENDPOINTS: To decrease the number of patients with residual dysfunction of the affected joint at the end of therapy and at 6 and 12 months and to speed clinical recovery by the administration of dexamethasone. METHODS: RESULTS: Of the 123 children enrolled, 61 were assigned to the dexamethasone group and 62 to the placebo group. Only 50 and 50 patients in each group were evaluable. The 2 groups of patients were comparable with respect to age, sex, duration of symptoms, pathogen, affected joint and therapeutic and diagnostic procedures. Staphylococcus aureus accounted for 67% of the isolates, Haemophilus influenzae type b for 13% and Streptococcus pneumoniae for 9%. Dexamethasone therapy reduced residual dysfunction at the end of therapy, P = 0.000068; at 6 months, P = 0.00007; and at 12 months, P = 0.00053 of follow-up and shortened the duration of symptoms (P = 0.001) during the acute phase. The 26% incidence of residual dysfunction in the control patients was similar to the 25% found in other series. CONCLUSIONS: A short course of dexamethasone reduced residual joint dysfunction and shortened significantly the duration of symptoms in children with documented hematogenous septic arthritis. These results suggest that a 4-day course of low dose dexamethasone given early benefits children with hematogenous septic arthritis.
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Authors | Carla M Odio, Tobias Ramirez, Gloria Arias, Arturo Abdelnour, Isabel Hidalgo, Marco L Herrera, Willy Bolaños, Jorge Alpízar, Patricio Alvarez |
Journal | The Pediatric infectious disease journal
(Pediatr Infect Dis J)
Vol. 22
Issue 10
Pg. 883-8
(Oct 2003)
ISSN: 0891-3668 [Print] United States |
PMID | 14551489
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anti-Bacterial Agents
- Dexamethasone
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Topics |
- Anti-Bacterial Agents
- Arthritis, Infectious
(drug therapy, microbiology, physiopathology)
- Blood-Borne Pathogens
- Chemotherapy, Adjuvant
- Confidence Intervals
- Costa Rica
- Dexamethasone
(administration & dosage)
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Administration Schedule
- Drug Therapy, Combination
(therapeutic use)
- Female
- Follow-Up Studies
- Humans
- Injections, Intravenous
- Male
- Pain Measurement
- Probability
- Range of Motion, Articular
(physiology)
- Recovery of Function
- Reference Values
- Risk Assessment
- Severity of Illness Index
- Treatment Outcome
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