Department of Orthopaedics, First Affiliated Hospital, Third Military Medical University (Army Medical University), Gaotanyan No. 30, Chongqing, 400038, People's Republic of China.
Department of Kidney, First Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, People's Republic of China.
BMC Musculoskelet Disord. 2020 Apr 7;21(1):215. doi: 10.1186/s12891-020-03214-4.
Our aim was to investigate the clinical efficacy and complications of antibiotic treatment regimens for patients with bone infection.
We retrospectively analysed patients with bone infection admitted to our hospital between March 2013 and October 2018. After surgical debridement was performed, the patients were divided into three groups: IV group (intravenous antibiotics for 2 weeks); oral group (intravenous antibiotics for 2 weeks followed by oral antibiotics for 4 weeks); and rifampicin group (intravenous antibiotics for 2 weeks followed by oral antibiotics plus rifampicin for 4 weeks). The infection control rate and complications were compared among the three groups.
A total of 902 patients were enrolled. The infection sites included 509 tibias, 228 femurs, 32 humeri, 23 radii and ulnae, 40 calcanei, and 47 miscellaneous sites, as well as 23 multiple-site infections. After at least 6 months of follow-up, 148 (16.4%) patients had an infection recurrence. The recurrence rate of the IV group was 17.9%, which was not significantly higher than the recurrence rates of the oral group (10.1%) and rifampicin group (10.5%), P = 0.051. The incidence of abnormal alanine aminotransferase (ALT) levels in the IV group was 15.1%, which was lower than that in the oral group (18.0%) and rifampicin group (27.4%), P = 0.026. The rates of proteinuria in the three groups were 3.2, 4.5, and 9.3%, respectively, P = 0.020.
After debridement of bone infection, short-term antibiotic treatment regimens might offer similar rates of infection eradication while avoiding the risk of renal and hepatic damage associated with prolonged antibiotic use.
Stage III.
我们旨在研究抗生素治疗方案对患有骨感染患者的临床疗效和并发症。
我们回顾性分析了 2013 年 3 月至 2018 年 10 月期间我院收治的骨感染患者。在进行外科清创后，将患者分为三组：静脉组（静脉用抗生素治疗 2 周）；口服组（静脉用抗生素治疗 2 周，然后口服抗生素治疗 4 周）；利福平组（静脉用抗生素治疗 2 周，然后口服抗生素加利福平治疗 4 周）。比较三组的感染控制率和并发症。
共纳入 902 例患者。感染部位包括 509 例胫骨、228 例股骨、32 例肱骨、23 例桡骨和尺骨、40 例跟骨和 47 例其他部位，以及 23 例多处感染。至少随访 6 个月后，148 例（16.4%）患者出现感染复发。静脉组的复发率为 17.9%，与口服组（10.1%）和利福平组（10.5%）的复发率无显著差异，P=0.051。静脉组丙氨酸氨基转移酶（ALT）水平异常发生率为 15.1%，低于口服组（18.0%）和利福平组（27.4%），P=0.026。三组蛋白尿发生率分别为 3.2%、4.5%和 9.3%，P=0.020。
骨感染清创后，短期抗生素治疗方案可能具有相似的感染清除率，同时避免了长期使用抗生素引起的肾肝损伤风险。
III 级。
