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Evaluación del impacto del Documento de Consenso español sobre el abordaje de las infecciones osteoarticulares en nuestro medio a través de la Red de Infecciones Osteoarticulares Pediátricas (RIOPed)

2020; Elsevier BV; Volume: 93; Issue: 5 Linguagem: Inglês

10.1016/j.anpedi.2019.11.008

1695-9531

Esmeralda Núñez Cuadros, Cristina Calvo, Jesús Saavedra‐Lozano, Rosa Alcobendas, Daniel Clemente, Francisco José Sanz-Santaeufemia, Leticia Martínez Campos, Alfredo Tagarro García, César G. Fontecha, Susana Melendo, Marisol Camacho Lovillo, Lola Falcón Neyra, M. José Lirola Cruz, Elena Colino Gil, Patricia Tejera Carreño, Luis Mayol Canals, Daniel Domenech Zarketa, M. Campana, Carlos Pérez Mendez, N. Rius Gordillo, Verónica Cardona, Jaime Carrasco Colom, Antonio Conejo Fernández, Marta García Ramírez, Rafael Díez Delgado, Carmen Vázquez Ordónez, Enrique Otheo de Tejada, José Couceiro Gianzo, Leonor Arranz, Carmen García-Pardos, Roi Piñeiro Pérez, Beatriz Bravo Mancheño, Inmaculada López-Molina, Adriana Vidal Acevedo, María Penín Antón, Mercé Coll, Berta Pujol Soler, Pilar Ranchal Pérez, Sara Morales, Belén Romero Sevilla, María Méndez Hernández, M. Jesús García-Mazarío, César Gavilán, Elisa Fernández-Cooke, Anna Canet, Marta Ruiz Jiménez, Marina González, Lourdes R. García, Carmen Moreno, Miren Oscoz Lizarbe, Laura Martín-Pedraz, Miguel Lillo, Antonio J. Cepillo, Pere Soler‐Palacín, Jan Ramakers, Olga Calavia Gasaball, Rebeca Lahoz Ramo, Pedro Terol Barrero, M. José Muñoz Vilchez, Victoria Fumadó Pérez, Sílvia Camps, Elena Urbaneja Rodríguez, María José Cilleruelo Ortega, Agustín López López, V. Pineda Solás, Carla Monterde Pedrab, Rosa Roldán Molina, Sandra Masegosa-Casanova, Paula Alcañiz Rodríguez, Ana Ruiz, Javier Arístegui-Fernández, Elisa Garrote, Federico Martinón‐Torres, Irene Rivero‐Calle, José Tomás Ramos, Marta Illán Ramos, Beatriz Jiménez Montero, Begoña Losada Pinedo, Borja Guarch Ibáñez, Marcelina Algar Serrano, María Dolores García García, Elena Guardiola Pereira, Silvia Rodríguez‐Blanco, M Fontan, Sagrario Bustabab Reyes, Antonio Medina Claros, Isabel Vives Oñós, M. Concepción Mir Perelló, Natalia Cerdeira Barreiro, María Ríos-Barnés, Isabel Vara Patudo, Soledad Martinez‐Regueira, Raquel Marín Domenech, Juan Salvador Vílchez, Jesús de la Cruz Moreno, C. Guerrero Laleona, Matilde Bustillo Alonso, Leticia Merino Meléndez, Azucena García Martín,

Clinical practice guidelines implementation

In 2014 the Consensus Document produced by the Spanish Paediatric Societies (SEIP-SERPE-SEOP) was published to help in the diagnosis and treatment of osteoarticular infections (OAI). In 2015 the RIOPed was considered as a multidisciplinary national network for the investigation into OAI. The aim of this study was to assess the level of adaption to the recommendations established in the Consensus during one year of follow-up.A prospective, national multicentre study was carried out in 37 hospitals between September 2015 and September 2016. The study included patients >16years-old with a diagnosis of OAI, confirmed by microbiological isolation, or probable: septic arthritis (SA) with >40,000 white cells in synovial fluid, or osteomyelitis (OM)/spondylodiscitis (SD) with a compatible imaging test. The results were compared with those obtained in a retrospective study conducted between 2008 and 2012.A total of 235 cases were included, of which 131 were OM, 79 SA, 30 OA, and 15 SD. As regards the complementary tests that the Consensus considered mandatory to perform, radiography was carried out on 87.8% of the cases, a blood culture on 91.6%, and culture of the synovial fluid in 99% of SA. A magnetic resonance (MR) was performed on 71% of the OM cases. The choice of intravenous empirical antibiotic treatment was adapted to the recommendations in 65.1% of cases, and in 62.3% for the oral treatment. Surgery was performed in 36.8% of SA cases (85.7% arthrotomy), with a significant decrease compared to the retrospective study (P=.014). Only 58.5% of cases followed the recommendations on the duration of the treatment; however, a lower duration of intravenous treatment was observed.In general, the level of adaptation to the recommendations that were set by the Expert Group, is good for the complementary tests, and acceptable as regards the choice of antibiotic treatment, although inadequate in almost 40% of cases. A decrease in hospital stay was achieved.