Background
Methods
Study design
Selection of participants
Data collection
Statistical analysis
Outcome measures
Results
Characteristics of the study sample
Characteristicsa | All Subjects (n = 584) |
---|---|
Age, years | 6.1 (1.9–11.0) |
Male | 60.6% |
Race/Ethnicity | |
Caucasian | 53.8% |
African-American | 32.7% |
Asian | 4.3% |
Hispanic | 1.5% |
Other/Unknown | 7.7% |
Race, collapsed | |
White vs non-white | 53.8% |
Duration of symptoms at presentation, days | 4.0 (3.0–7.0) |
Fever ≥38 °C at presentation | 79.0% |
Initial WBCb count (×109/L) | 11.6 (8.8–15.4) |
Initial ESRc (mm/h) | 45.0 (28.0–66.0) |
Initial CRPd (mg/dL) | 6.7 (3.0–16.0) |
Impact of antibiotics on culture yield
Culture Type | N | Rate of Culture Positivity | ||||
---|---|---|---|---|---|---|
Overall (%) | Pretreated (%) | Not Pretreated (%) | P-value | Effect Size | ||
Blood Culture | 525 | 221 (42%) | 55 (44%) | 166 (42%) | 0.62 | 0.04 |
Bone Culture | 90 | 63 (70%) | 38 (75%) | 25 (64%) | 0.29 | 0.25 |
Joint Culture | 265 | 103 (39%) | 36 (39%) | 67 (39%) | 0.95 | 0.01 |
Other Culture | 197 | 138 (70%) | 103 (74%) | 35 (61%) | 0.09 | 0.26 |
Predictor | Culture | Comparison (reference = no pretreatment) | Odds Ratio for Positive Culture | |
---|---|---|---|---|
Pretreatment (vs. none) with antibiotics | ORa (95% CIb) | P-value | ||
N = 525 | Blood | – | 0.90 (0.56–1.44) | 0.66 |
N = 90 | Bone | – | 0.77 (0.25–2.34) | 0.64 |
N = 262 | Joint | – | 0.71 (0.39–1.28) | 0.26 |
N = 196 | Other | – | 1.18 (0.58–2.41) | 0.65 |
Hours of antibiotics (for pretreated cultures) | Culture | Comparison (reference = 0- < 4 h) | OR (95% CI) | P-value |
N = 113 | Blood | 4 to < 24 h | 1.24 (0.44–3.52) | 0.90 |
> 24 h | 1.34 (0.35–5.22) | 0.78 | ||
N = 50 | Bone | 4 to < 24 h | 1.11 (0.06–19.93) | 0.90 |
> 24 h | 1.57 (0.08–31.4) | 0.68 | ||
N = 91 | Joint | 4 to < 24 h | 1.36 (0.36–5.06) | 0.93 |
> 24 h | 1.67 (0.35–8.01) | 0.58 | ||
N = 139 | Other | 4 to < 24 h | 0.77 (0.24–2.46) | 0.28 |
> 24 h | 1.60 (0.44–5.77) | 0.25 |