Mohr J A, Griffiths W, Holm R, Garcia-Moral C, Flournoy D J
JAMA. 1978 Feb 27;239(9):847-9.
Four cases of clostridial myonecrosis that developed in open fractures were treated with surgical debridement and with intravenous cephalosporins as antibiotic prophylaxis. All patients recovered following amputation of the involved extremity, and treatment with high-dose penicillin in three cases, and erythromycin plus high-dose cephalothin in the fourth. This complication was not seen in patients with similar injuries that were managed surgically but used other antibiotics, usually penicillin, as prophylaxis. In vitro susceptibility tests of clostridia to cephalothin were performed; the results demonstrated that nearly 50% of clostridia tested were resistant to cephalothin.
4例开放性骨折并发梭菌性肌坏死患者接受了手术清创，并静脉注射头孢菌素作为抗生素预防措施。所有患者在截肢受累肢体后均康复，3例患者接受了大剂量青霉素治疗，第4例患者接受了红霉素加大剂量头孢噻吩治疗。在接受手术治疗但使用其他抗生素（通常为青霉素）作为预防措施的类似损伤患者中未发现这种并发症。对梭菌进行了头孢噻吩的体外药敏试验；结果表明，近50%的受试梭菌对头孢噻吩耐药。
