Actively Recruiting

Phase 4
Age: 1Year - 18Years
All Genders
ID04538053

BonE and Joint Infections - Simplifying Treatment in Children Trial

Led by Murdoch Childrens Research Institute · Updated on 2025-11-17

285

Participants Needed

10

Research Sites

N/A

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating treatment options for children aged 1 to 18 years with acute, uncomplicated bone and joint infections (BJIs) in a multi-center trial across eight major pediatric hospitals in Australia and New Zealand. The study aims to determine if treating these infections entirely with oral antibiotics is not worse than the standard approach, which begins with 1 to 7 days of intravenous (IV) antibiotics followed by oral antibiotics. The goal is to see if children can fully recover without the need for IV treatment at 3 months after starting therapy. Children in the trial are randomly assigned to one of two groups. One group receives high-dose oral cefalexin four times daily for 1 to 7 days, followed by a standard dose of oral cefalexin three times daily to complete a total 3-week course. The other group receives standard treatment with IV cefazolin or IV flucloxacillin for 1 to 7 days, then oral cefalexin three times daily for 3 weeks. This comparison will help assess whether the oral-only treatment can effectively replace initial IV therapy. Throughout the study, children will be monitored for recovery status at 3 months, including assessment of full recovery, disease recurrence at 6 and 12 months, and any complications or treatment-related side effects. Researchers will also evaluate quality of life using various pediatric health scales, treatment adherence, and cost-effectiveness over 12 months. Medication use and adherence will be reviewed at 3 weeks to understand how well children follow the treatment plan.

CONDITIONS

Brief Title

BonE and Joint Infections - Simplifying Treatment in Children Trial

Who Can Participate

Age: 1Year - 18Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Children aged 1 to 18 years
  • Acute, uncomplicated, community-acquired bone and joint infection
  • Fulfill pre-defined clinical criteria for the infection
Not Eligible

You will not qualify if you...

  • Infection caused by bacteria resistant to cefalexin or atypical infections such as mycobacterial or fungal
  • Presence of sepsis with organ dysfunction as defined by Pediatric Logistic Organ Dysfunction-2 score
  • Severe invasive infections like necrotising fasciitis
  • Complicated infections including prosthetic material, large subperiosteal or soft tissue abscess without surgery, or infections related to trauma
  • Allergy to cephalosporin antibiotics or severe immediate reactions to penicillins
  • More than three doses of IV or oral antibiotics received for the current infection
  • Previous episode of osteomyelitis or septic arthritis
  • Conditions causing poor absorption or complicated disease such as inflammatory bowel disease or immunodeficiency
  • Prior participation in this trial
  • Currently receiving another investigational product in a clinical trial

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - 1 to 7 days of initial antibiotics followed by 3 weeks of oral antibiotics

Participants receive either high-dose oral antibiotics alone or initial IV antibiotics followed by oral antibiotics for bone and joint infections.

Weekly visits for up to 4 weeks

Follow-up

Duration - Up to 12 months

Participants are assessed for recovery, recurrence, complications, quality of life, treatment adherence, and adverse effects after treatment completion.

Visits at 3 weeks, 3 months, 6 months, and 12 months

Trial Site Locations

Total: 10 locations

1

Nepean Hospital

Kingswood, New South Wales, Australia, 2747

Actively Recruiting

2

John Hunter Children's Hospital

New Lambton Heights, New South Wales, Australia, 2305

Actively Recruiting

3

Sydney Children's Hospital Network

Sydney, New South Wales, Australia, 2031

Actively Recruiting

4

The Children's Hospital at Westmead

Sydney, New South Wales, Australia, 2145

Active, Not Recruiting

5

Royal Darwin Hospital

Darwin, Northern Territory, Australia, 0811

Actively Recruiting

6

Queensland Children's Hospital

Brisbane, Queensland, Australia, 4101

Actively Recruiting

7

Women's and Children's Hospital

Adelaide, South Australia, Australia, 5006

Actively Recruiting

8

The Royal Children's Hospital

Melbourne, Victoria, Australia, 3051

Actively Recruiting

9

Perth Children's Hospital

Perth, Western Australia, Australia, 6009

Actively Recruiting

10

Christchurch Hospital

Christchurch, New Zealand, 8011

Actively Recruiting

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Research Team

A

Alison Boast, MD

A

Amanda Gwee, PhD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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