Antibiotic Treatment Duration for Salmonella Osteoarticular Infections in Children - A Systematic Review and Comparative Study.

AIM: Current guidelines based on expert opinions recommend a minimum of 4-6 weeks of antibiotic treatment for paediatric Salmonella osteoarticular infections. In this study, we aim to validate guidelines and investigate the duration of antibiotic treatment.

METHODS

PubMed, Medline, Embase, Scopus, and Google Scholar were searched for cases according to the PRISMA guidelines. We included all paediatric cases from January 1990 to December 2025 with confirmed Salmonella osteoarticular infection.

RESULTS

Outcome was reported in 173 (81%) of 214 children; 117 (68%) previously healthy children fully recovered after a median antibiotic treatment duration of 6.0 weeks, and 32 (18%) children with comorbidities including sickle cell disease fully recovered after a median duration of 8.0 weeks. For all children, approximately half of the treatment duration was administered intravenously. Multivariable logistic regression analysis demonstrated no independent association between antibiotic treatment duration and outcome.

CONCLUSION

The majority of children fully recovered after an antibiotic treatment duration within the current guidelines of minimum four weeks in case of joint infection only and six weeks in case of bone infection. The variation in antibiotic treatment durations was substantial. Individualized treatment durations within the recommended timeframe seem reasonable based on the clinical and paraclinical response.