Shorter courses of parenteral antibiotic therapy do not appear to influence response rates for children with acute hematogenous osteomyelitis: a systematic review
Shorter courses of parenteral antibiotic therapy do not appear to influence response rates for children with acute hematogenous osteomyelitis: a systematic review
复制标题
DOI：
10.1186/1471-2334-2-16
复制
发表时间：
2002-08-14
影响因子：
3.7
通讯作者：
Moher, D
中科院分区：
文献类型：
--
作者：
Le Saux, N;Howard, A;Moher, D
背景：急性血源性骨髓炎（AHO）主要发生在儿童中，据信是由菌血症演变而来，随后感染局限于骨干骺端。目前，对于治疗 AHO 的抗菌治疗途径和持续时间尚未达成共识。方法：我们对 3 个月至 16 岁儿童主要由金黄色葡萄球菌引起的 AHO 的短期与长期治疗进行了系统评价。我们检索了 Medline、Embase 和 Cochrane 试验注册中心的对照试验。 6 个月时的临床治愈率是主要结果变量，将接受少于 7 天静脉注射治疗的组与接受一周或更长时间静脉注射抗菌药物的组进行比较。结果：确定了 12 项符合条件的前瞻性研究，其中一项是随机的。短期静脉治疗的 6 个月总体治愈率为 95.2% (95% CI = 90.4, 97.7)，而较长疗程的治疗为 98.8% (95% CI = 93.6, 99.8)。对于较长疗程的治疗，与 98.8%（95% CI = 93.6, 99.8）相比没有显着性。对于较长疗程的治疗，与 98.8%（95% CI = 93.6, 99.8）相比没有显着性。两组之间的口服治疗持续时间没有显着差异。结论：鉴于与更长的静脉治疗疗程相关的发病率和费用可能增加，这一发现应通过随机对照等效试验来证实。
Background: Acute hematogenous osteomyelitis (AHO) occurs primarily in children and is believed to evolve from bacteremia followed by localization of infection to the metaphysis of bones. Currently, there is no consensus on the route and duration of antimicrobial therapy to treat AHO.Methods: We conducted a systematic review of a short versus long course of treatment for AHO due primarily to Staphylococcus aureus in children aged 3 months to 16 years. We searched Medline, Embase and the Cochrane trials registry for controlled trials. Clinical cure rate at 6 months was the primary outcome variable, and groups receiving less than 7 days of intravenous therapy were compared with groups receiving one week or longer of intravenous antimicrobials.Results: 12 eligible prospective studies, one of which was randomized, were identified. The overall cure rate at 6 months for the short course of intravenous therapy was 95.2% (95% CI = 90.4, 97.7) compared to 98.8% (95% CI = 93.6, 99.8) for the longer course of therapy. There was no significant compared to 98.8% (95% CI = 93.6, 99.8) for the longer course of therapy. There was no significant compared to 98.8% (95% CI = 93.6, 99.8) for the longer course of therapy. There was no significant difference in the duration of oral therapy between the two groups.Conclusions: Given the potential increased morbidity and cost associated with longer courses of intravenous therapy, this finding should be confirmed through a randomized controlled equivalence trial.