Aim: The literature suggests that the incidence of osteomyelitis in the paediatric population has changed. We undertook to examine changes in incidence, causative organisms and treatment regimes over a 13 year period.

Methods: Patients admitted with a diagnosis of osteomyelitis between January 1991 and January 2004 were identified from hospital records and data collected from their medical and laboratory records.

Results: A total of 362 patients were admitted over the study period with a mean age of 5.9 years. A significant decrease in the number of patients presenting over the study period with osteomyelitis was noted, from a peak of 77 cases in 1991 to 12 cases in 2003 (p< 0.05). There was no significant difference in patient age or length of hospital stay over the study period. The majority of cases involved the lower appendicular skeleton with Staphylcoccus Aureus being the commonest organism cultured (accounting for 60% of positive cultures). All cases were initially treated empirically with intravenous Flucloxicillin and oral Fusidic acid. Surgical debridement/decompression was required in 11% of cases.

Conclusion: Osteomyelitis now appears to be a rare condition in children with a marked decrease in the incidence being noted over the study period. This correlates with the introduction of the Haemophilus Influenzae B vaccination in Ireland and may partly explain the decrease in incidence. The majority of cases settled on a course of non-operative management.