What is the recommended empirical antibiotic therapy for osteomyelitis in children?

The recommended empirical antibiotic therapy for osteomyelitis in children is typically a combination of a third-generation cephalosporin, like ceftriaxone or ceftazidime, and vancomycin. This choice effectively covers a broad range of potential pathogens, particularly Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA), as well as streptococci and gram-negative bacilli.

Third-generation cephalosporins provide excellent coverage for common organisms associated with osteomyelitis in children, which can include both aerobic and anaerobic bacteria. Vancomycin is essential for its activity against MRSA, an increasingly common cause of osteomyelitis, especially in cases of hematogenous spread or after trauma.

This combination of antibiotics also accounts for the possibility of polymicrobial infections, as is often seen in cases resulting from puncture wounds or post-surgical situations.

In summary, the rationale behind combining a third-generation cephalosporin with vancomycin is to ensure broad-spectrum coverage against a variety of pathogens that may cause osteomyelitis in the pediatric population, which is why this answer is the most appropriate for empirical treatment in these cases.