ORAL CIPROFLOXACIN COMPARED WITH PARENTERAL ANTIBIOTICS IN THE TREATMENT OF OSTEOMYELITIS
ORAL CIPROFLOXACIN COMPARED WITH PARENTERAL ANTIBIOTICS IN THE TREATMENT OF OSTEOMYELITIS
复制标题
DOI：
10.1128/aac.34.1.40
复制
发表时间：
1990-01-01
影响因子：
4.9
通讯作者：
RODRIGUEZ, GG
中科院分区：
文献类型：
--
作者：
GENTRY, LO;RODRIGUEZ, GG
我们进行了一项前瞻性、随机比较口服环丙沙星与标准肠外疗法治疗经活检证实由易感微生物引起的骨髓炎。手术清创后，环丙沙星患者接受750毫克，每天两次，和其他患者接受广谱头孢菌素或萘夫西林-氨基糖苷类组合静脉注射（i. v.）。环丙沙星组有31例可评价患者，平均治疗56天，静脉注射组有28例可评价患者，平均治疗47天。环丙沙星组的临床成功率为24/31（77%），静脉注射组为22/28（79%）。在环丙沙星组的7例失败中，1例是由于持续性肺炎克雷伯菌感染，6例是由于治疗1年内感染复发。在静脉注射组的6例失败中，1例是由于产气肠杆菌菌株出现耐药性，5例是由于复发。最棘手的病因是涉及铜绿假单胞菌的多微生物骨髓炎，其中6种治疗方案中有5种（83%）失败。不良反应很少发生，即，在31名环丙沙星患者中的1名（3%）和28名静脉注射患者中的4名（14%）中，但所有反应均对治疗有反应，且均不需要偏离方案。我们的数据表明，口服环丙沙星单药治疗敏感微生物引起的骨髓炎与传统的肠外治疗一样安全有效。
We undertook a prospective, randomized comparison of oral ciprofloxacin with standard parenteral therapies for the treatment of biopsy-proven osteomyelitis caused by susceptible organisms. Following surgical debridement, the ciprofloxacin patients received 750 mg twice a day, and the other patients received a broad-spectrum cephalosporin or a nafcillin-aminoglycoside combination intravenously (i.v.). There were 31 evaluable patients in the ciprofloxacin group, treated an average of 56 days, and 28 in the i.v. group, treated an average of 47 days. Clinical success rates were 24 of 31 (77%) for the ciprofloxacin group and 22 of 28 (79%) for the i.v. group. Of the seven failures in the ciprofloxacin group, one was due to a persistent Klebsiella pneumoniae infection and six were due to relapse of the infection within 1 year of therapy. Of the six failures in the i.v. group, one was due to an Enterobacter aerogenes strain which emerged resistant and five were due to relapse. The most troublesome etiology was polymicrobial osteomyelitis involving Pseudomonas aeruginosa, in which five of six (83%) regimens failed. Adverse reactions occurred infrequently, i.e., in 1 of 31 (3%) of the ciprofloxacin patients and in 4 of 28 (14%) of the i.v. patients, yet all reactions responded to therapy and none required protocol deviation. Our data indicate that oral ciprofloxacin monotherapy is as safe and effective as conventional parenteral therapy in cases of osteomyelitis caused by susceptible organisms.