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小儿急性骨髓炎和化脓性关节炎的治疗进展

Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis.

作者信息

Castellazzi Luca, Mantero Marco, Esposito Susanna

机构信息

Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Respiratory Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

出版信息

Int J Mol Sci. 2016 Jun 1;17(6):855. doi: 10.3390/ijms17060855.

Abstract

Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of parenteral antibiotics followed by oral therapy is safe and effective. The aim of this review is to provide clinicians an update on recent controversies and advances regarding the management of acute osteomyelitis and septic arthritis in children. In recent years, the emergence of bacterial species resistant to commonly used antibiotics that are particularly aggressive highlights the necessity for further research to optimize treatment approaches and to develop new molecules able to fight the war against acute osteoarticular infection in pediatric patients.

摘要

急性骨髓炎和化脓性关节炎是两种在儿科患者中发病率不断上升的感染性疾病。急性骨髓炎和化脓性关节炎需要进行仔细评估、诊断和治疗,以避免出现严重后果。传统上,儿科急性骨关节感染的治疗基于长时间的静脉抗感染治疗。然而,临床试验结果表明,在非复杂性病例中,短期(几天)的肠外抗生素治疗后继以口服治疗是安全有效的。本综述的目的是为临床医生提供有关儿童急性骨髓炎和化脓性关节炎治疗方面近期争议和进展的最新信息。近年来,对常用抗生素耐药且具有特别强侵袭性的细菌种类的出现,凸显了进一步开展研究以优化治疗方法并研发能够对抗儿科患者急性骨关节感染的新药物的必要性。

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