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两种新型头孢菌素(头孢唑林和头孢匹林)间歇性给药治疗儿童急慢性骨髓炎的有效性。

Effectiveness of two new cephalosporins, cephazolin and cephapirin, administered intermittently in acute and chronic osteomyelitis in children.

作者信息

Arango J L, Trujillo H, Worren D, Uribe A, Agudelo N H, de Vidal E L

出版信息

J Int Med Res. 1976;4(3):183-94. doi: 10.1177/030006057600400307.

Abstract

Ten patients were treated, most of pre-school age, with acute osteomyelitis, produced by Staphylococcus aureus and Salmonella, having evolved for approximately one week, with sodium cephazolin at doses of 60 mg/kg/day intramuscularly in two daily injections for the first seven days and then in a single dose every twenty-four hours for four to seven weeks. Nine of ten patients were asymptomatic six months after this treatment. The patient who manifested chronic signs at the end of six weeks of therapy continued to be treated with three weekly injections of the same drug at an equal dose until the completion of six months, at the end of which he was asymptomatic. Ten patients with chronic osteomyelitis having evolved for two months to five years, due to penicillin-resistant Staphylococcus aureus, were treated with cephapirin at the dose of 30 mg/kg in one daily injection intramuscularly for three to four weeks and then the same dose on Mondays, Wednesdays and Fridays until the completion of six months. Eight patients who required it were sequestrectomized. Seven of the ten patients improve and remained asymptomatic for the same period of observation. The three patients who did not show marked clinical improvement did exhibit an appreciable radiological recovery. We have presented these regimens of treatment with a view of encouraging research into the intermittent administration of bactericidal antibiotics for pyogenic infections; in spite of the good results, we do not dare to recommend them in daily practice.

摘要

对10例患者进行了治疗,这些患者大多为学龄前儿童,患有由金黄色葡萄球菌和沙门氏菌引起的急性骨髓炎,病程约一周,给予头孢唑林钠治疗,前7天剂量为60mg/kg/天,分两次肌肉注射,之后每24小时一次单剂量,持续4至7周。10例患者中有9例在该治疗后6个月无症状。在治疗6周结束时仍有慢性症状的患者继续接受相同药物每周三次、同等剂量的注射,直至6个月结束,此时他已无症状。10例因耐青霉素金黄色葡萄球菌导致慢性骨髓炎、病程已达2个月至5年的患者,接受头孢匹林治疗,剂量为30mg/kg,每日一次肌肉注射,持续3至4周,然后在周一、周三和周五注射相同剂量,直至6个月结束。8例有需要的患者接受了死骨切除术。10例患者中有7例病情改善,并在相同观察期内保持无症状。3例未表现出明显临床改善的患者在影像学上有明显恢复。我们展示了这些治疗方案,旨在鼓励对化脓性感染采用杀菌性抗生素间歇给药进行研究;尽管结果良好,但我们不敢在日常实践中推荐这些方案。

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