Approach to managing osteomyelitis in children with sepsis or septic shock

For children with osteomyelitis who have signs and symptoms of sepsis or septic shock, urgent empirical therapy is required. Start antibiotic therapy within 1 hour of presentation to medical care or, for ward-based patients, development of sepsis or septic shock. Antibiotics should be administered immediately after blood samples are taken for culture. If required, collect bone samples as soon as possible; however, do not delay antibiotic administration to do so. Children with osteomyelitis associated with sepsis or septic shock should be treated as for community-acquired sepsis or septic shock of uncertain source. For children 2 months or older, see the regimens here. For children 1 month to younger than 2 months, see the regimens here. For nonantibiotic management of sepsis or septic shock, see Resuscitation of patients with sepsis or septic shock.