P2, N=200, Active, not recruiting, Prisma Health-Upstate | Trial primary completion date: Dec 2025 --> Dec 2026

P2, N=25, Not yet recruiting, Nantes University Hospital | Trial completion date: Jul 2026 --> Oct 2026

P4, N=1770, Completed, Duke University | Active, not recruiting --> Completed | Trial completion date: Dec 2025 --> Aug 2025

Among the 59 pediatric patients, 34 cases (58%) were treated with trimethoprim-sulfamethoxazole monotherapy, 19 cases (32%) received combination therapy with micafungin, and 7 cases (12%) received combination therapy with clindamycin. Clinical manifestations and imaging findings lack specificity, and mNGS facilitates early diagnosis. The core treatment is trimethoprim-sulfamethoxazole, most children require respiratory support, and combination with low-dose glucocorticoids may improve prognosis.

P=N/A, N=260, Recruiting, University Hospital, Strasbourg, France

P1, N=72, Active, not recruiting, Wake Forest University Health Sciences | Recruiting --> Active, not recruiting | Trial primary completion date: Feb 2026 --> Jun 2025

P2, N=25, Not yet recruiting, Nantes University Hospital

P4, N=202, Completed, Hospital de Clinicas de Porto Alegre | Unknown status --> Completed

P=N/A, N=100, Completed, Ain Shams Maternity Hospital

P=N/A, N=0, Withdrawn, Zimmer Biomet | N=108 --> 0 | Not yet recruiting --> Withdrawn

This case illustrates the potential limits of monotherapy with beta-lactams in native joint infections caused by G. haemolysans, especially in immunocompromised patients. The failure of amoxicillin may be explained by factors such as limited diffusion into joint tissues, the absence of surgical debridement, and the use of pharmacokinetic and pharmacodynamic breakpoints not specifically validated for this rare species. Early reassessment and combination therapy may be warranted, particularly in immunocompromised individuals.

P4, N=1770, Active, not recruiting, Duke University | Trial completion date: Aug 2025 --> Dec 2025