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头孢洛林酯在2例侵袭性耐甲氧西林金黄色葡萄球菌感染儿科患者中的应用

Ceftaroline Fosamil Use in 2 Pediatric Patients With Invasive Methicillin-Resistant Staphylococcus aureus Infections.

作者信息

Williams Amanda W, Newman Patrick M, Ocheltree Sara, Beaty Rachel, Hassoun Ali

机构信息

Department of Pharmacy, Huntsville Hospital for Women and Children, Huntsville, Alabama.

Huntsville Hospital, Huntsville, Alabama.

出版信息

J Pediatr Pharmacol Ther. 2015 Nov-Dec;20(6):476-80. doi: 10.5863/1551-6776-20.6.476.

Abstract

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is one of the most common pathogens causing pediatric infections including skin and soft tissue infections, pyogenic arthritis, osteomyelitis, and septic shock. For decades, patients were treated with antibiotics such as vancomycin and clindamycin, but there is an increasing incidence of resistance to these traditional therapies. We describe 2 cases of patients with CA-MRSA invasive infections with bacteremia who experienced vancomycin therapy failure but who were successfully treated with ceftaroline fosamil. Case 1 involves an 8-year-old Hispanic male who was diagnosed with CA-MRSA bacteremia, thigh abscess, and osteomyelitis. The patient was admitted to the pediatric intensive care unit in septic shock. Case 2 involves an 8-year-old Caucasian male who was diagnosed with CA-MRSA sepsis, right arm abscess, and osteomyelitis. We were able to successfully treat both patients with CA-MRSA sepsis and invasive infection-who failed vancomycin therapy-with ceftaroline fosamil with no adverse efiects. Despite the positive outcome in both pediatric patients, clinical trials with ceftaroline fosamil are needed to further support its use in pediatric patients.

摘要

社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)是引起儿童感染的最常见病原体之一,包括皮肤和软组织感染、化脓性关节炎、骨髓炎和感染性休克。几十年来,患者一直使用万古霉素和克林霉素等抗生素进行治疗,但对这些传统疗法的耐药率在不断上升。我们描述了2例CA-MRSA侵袭性感染合并菌血症的患者,他们经历了万古霉素治疗失败,但使用头孢洛林酯成功治愈。病例1是一名8岁的西班牙裔男性,被诊断为CA-MRSA菌血症、大腿脓肿和骨髓炎。该患者因感染性休克入住儿科重症监护病房。病例2是一名8岁的白人男性,被诊断为CA-MRSA败血症、右臂脓肿和骨髓炎。我们能够成功治疗这2例CA-MRSA败血症和侵袭性感染且万古霉素治疗失败的患者,使用头孢洛林酯,未出现不良反应。尽管这两名儿科患者都取得了积极的治疗效果,但仍需要进行头孢洛林酯的临床试验,以进一步支持其在儿科患者中的应用。

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