Reduced incidence of septic arthritis in children by Haemophilus influenzae type-b vaccination. Implications for treatment

J Bone Joint Surg Br. 1998 May;80(3):471-3. doi: 10.1302/0301-620x.80b3.8296.

Abstract

In many countries Haemophilus influenzae type b (Hib) is the second most common cause of septic arthritis in children. In Finland large-scale immunisation against Hib using conjugate vaccines began in 1986, four years after a multicentre prospective study of orthopaedic infections in children had started. Since 1982, including six years before and ten after starting routine Hib vaccination, there has been a major change in the pattern of septic arthritis. From 1982 to 1988, 32 of 61 cases (53%) were caused by staphylococci, 22 (36%) by Hib and 7 (11%) by other bacteria. Since 1988, Hib infection has disappeared, and one-third of cases of childhood septic arthritis has been eliminated. This change has allowed us to reduce initial antimicrobial therapy for such children to cover only Gram-positive cocci. The more limited treatment is safer, reduces cost, and simplifies treatment.

MeSH terms

  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use
  • Arthritis, Infectious / drug therapy
  • Arthritis, Infectious / prevention & control*
  • Cephalosporins / economics
  • Cephalosporins / therapeutic use
  • Child
  • Child, Preschool
  • Clindamycin / economics
  • Clindamycin / therapeutic use
  • Cost Control
  • Diphtheria Toxoid / administration & dosage
  • Finland
  • Gram-Positive Bacterial Infections / drug therapy
  • Haemophilus Infections / prevention & control*
  • Haemophilus Vaccines* / administration & dosage
  • Haemophilus influenzae type b*
  • Humans
  • Immunization
  • Incidence
  • Infant
  • Multicenter Studies as Topic
  • Prospective Studies
  • Safety
  • Staphylococcal Infections / drug therapy
  • Tetanus Toxoid / administration & dosage
  • Vaccination*
  • Vaccines, Conjugate / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Diphtheria Toxoid
  • Haemophilus Vaccines
  • Tetanus Toxoid
  • Vaccines, Conjugate
  • Clindamycin