Mader J T, LeFrock J L, Hyams K C, Molavi A, Reinarz J A
Rev Infect Dis. 1982 Sep-Oct;4 Suppl:S472-80. doi: 10.1093/clinids/4.supplement_2.s472.
Cefotaxime, a new cephalosporin, was evaluated for efficacy and safety in the treatment of 52 patients with serious bone and joint infections. For five of these patients therapy could not be evaluated. Diagnosis of osteomyelitis or septic arthritis was made on the basis of clinical and roentgenographic evidence of infection. The diagnosis of a bone infection was confirmed by either a positive culture of a bone biopsy or of blood in combination with a positive bone scan or roentgenogram. The diagnosis of a joint infection was confirmed by a positive culture of joint aspirate samples. Osteomyelitis was arrested in 93% (15 of 16 patients) of cases of acute osteomyelitis, 89% (24 of 27 patients) of cases of chronic osteomyelitis, and 100% (4 of 4 patients) of cases of septic arthritis. Follow-up ranged from 0-17 months after completion of cefotaxime therapy. Laboratory monitoring revealed positive direct Coombs' test (six patients), neutropenia less than 1,000 polymorphonuclear leukocytes (two patients), macular rash (two patients), phlebitis (two patients), and pseudomembranous colitis (one patient). It is concluded that cefotaxime is a useful and safe antibiotic for the treatment of osteomyelitis and septic arthritis.
头孢噻肟是一种新型头孢菌素，对52例严重骨和关节感染患者的疗效及安全性进行了评估。其中5例患者的治疗效果无法评估。骨髓炎或化脓性关节炎的诊断基于感染的临床和X线证据。骨感染的诊断通过骨活检培养阳性或血培养阳性并结合骨扫描或X线片阳性来确诊。关节感染的诊断通过关节穿刺液培养阳性来确诊。急性骨髓炎患者中93%（16例中的15例）、慢性骨髓炎患者中89%（27例中的24例）以及化脓性关节炎患者中100%（4例中的4例）的骨髓炎得到控制。头孢噻肟治疗结束后的随访时间为0至17个月。实验室监测发现直接抗人球蛋白试验阳性（6例患者）、中性粒细胞减少（多形核白细胞少于1000个，2例患者）、斑丘疹（2例患者）、静脉炎（2例患者）以及假膜性结肠炎（1例患者）。结论是头孢噻肟是治疗骨髓炎和化脓性关节炎的一种有效且安全的抗生素。
