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