Wednesday, September 16, 2015

Dexamethasone for Septic Arthritis? Does It Make a Difference?

By: Lewis First, MD, MS; Editor-in-Chief         
       We can all note the benefits of using dexamethasone in a number of disease processes, but how many of us think about it when a child presents with a septic joint?  Fogel et al. (doi: 10.1542/peds.2014-4025) opted to study the effect of dexamethasone in combination with antibiotics in hospitalized children at one pediatric center.   
      While not randomized, 26 of the 116 patients with septic arthritis got antibiotics and dexamethasone. There were not striking differences in the demographics of who did and did not get the steroid. Yet when children received dexamethasone in this study, there were marked clinical improvements including shorter duration of fever, faster clinical improvement, quicker drop in C-reactive protein as a marker of inflammation and others including a shorter hospital stay. 
      Just how much dexamethasone to use, and what if any side effects occurred, as well as lots of other interesting information about this newer usage of a steroid in combination with antibiotics awaits your perusal by linking to this study being released this week.  Have you used dexamethasone in the care of your patients with septic arthritis? If so, tell us about it by responding to this blog, sending us an e-letter, or posting your comments on our Facebook or Twitter sites.

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