Osteomyelitis (being treated with antibiotics)

Advice for parents or carers taking their child home after seeing a hospital-based healthcare professional.

Osteomyelitis is an infection of the bone. Any part of the bone can be affected.

  • Pain in the affected area especially when your child moves. This may prevent your child from straightening the affected limb.
  • The pain usually starts suddenly, although there may have been a previous injury to the affected area.
  • Fever
  • Your child may become unsettled or miserable.

Osteomyelitis can be caused by bacteria spreading from an existing infection or as a result of an injury such as a deep wound. For children, there is often no obvious cause for the infection.

When to seek further help:

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Has blue lips
  • Severe breathing difficulty - too breathless to talk / eat or drink
  • Has a fit / seizure
  • Becomes extremely agitated, confused or very lethargic (difficult to wake)

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Increase in pain, swelling, redness, stiffness, and warmth in the affected area.
  • Is finding it hard to breathe
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Has had chickenpox in the past few days and is now getting more unwell with a high fever and spreading red rash
  • Swelling of a limb or joint
  • Too painful for your child to stand
  • Has a swollen eye
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried

You need to contact the discharging ward urgently

  • If none of the above features are present

Self Care

Continue providing your child’s care at home using the advice below. If you are still concerned about your child, speak to your health visitorlocal pharmacist or call NHS 111– dial 111. Keep monitoring your child for red and amber features and seek help if they develop


Your child will need to have antibiotics to treat the infection. At first, we usually give these directly into the bloodstream (intravenous) via a cannula (a small plastic tube). the antibiotics may sting when they are being given and they can sometimes cause redness. We will decide how long your child needs to have antibiotics depending on where the infection is and how well your child responds to the treatment. We will do some blood tests to check that the antibiotics are working. When your child's temperature is back to normal, their blood results show that the medicine is working, and their pain has improved, the doctor may decide they can have their antibiotics as a syrup or tablets. We usually give antibiotics for four to six weeks. Some children may also need to have surgery.

What else can you do to help?

It is very important to make sure your child keeps taking every dose of their oral antibiotics so that they recover from the infection and prevent it coming back. Your child must take the entire course of antibiotics, as directed by their health care professional.

You can give your child regular pain relief (paracetamol or ibuprofen) until the pain has improved. Please note: do not give your child ibuprofen if they have chicken pox.

If your child has a plaster cast, we will show you how to look after it.


Osteomyelitis usually clears up completely when a child has treatment for it. and children do not usually experience long-term complications. The orthopaedic team will review your child to monitor their progress.

If you are concerned that your child's condition is getting worse, you should contact the hospital urgently - you'll find the contact details on the information you were provided with when your child was discharged.

Symptoms to look out for:

  • Fever
  • Fast breathing
  • Fast heartbeat
  • Changes in behaviour, such as confusion or disorientation
  • Increase in pain, swelling, redness, stiffness, and warmth in the affected area.


Preventing osteomyelitis reoccurring

  • Mak sure your child takes their entire course of antibiotics as directed by their health care professional.
  • Keep your child's skin clean. All cuts and wounds, especially deep wounds should be cleaned well.
  • Your child will also have follow-up appointments after they leave hospital. It is important to keep these appointments, even if your child seems well.
  • Both you and your child should wash your hands well to stop the spread of germs,

For more information on keeping your child healthy, click here.

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