Proper care for children with AHO is inherently a multidisciplinary and collaborative process that should be guideline driven and evidence based.

AHO is the most difficult condition to understand in the realm of pediatric musculoskeletal infection and continues to present a significant clinical challenge due to the evolving epidemiology and complex pathogenesis.

A lack of institutional consensus as to the most effective evaluation and management strategies may lead to variation in care, which in turn may have an adverse impact on clinical outcomes. Such variability, which may easily occur in large pediatric medical centers, can make coordination of care extremely difficult.

Despite these challenges, a guideline-driven, multidisciplinary approach has been introduced and shown to effectively reduce hospital stay, improve the timing and selection of empirical antibiotic administration, reduce delay to initial MRI, reduce the rate of readmission, and shorten antibiotic duration.

Carefully monitoring regional trends in microbiologic epidemiology and applying a guideline-driven approach for evaluation and treatment will improve care for children with AHO and, inevitably, those with other forms of musculoskeletal infection as well.