ADJUVANT FOSFOMYCIN MEDICATION IN CHRONIC OSTEOMYELITIS
ADJUVANT FOSFOMYCIN MEDICATION IN CHRONIC OSTEOMYELITIS
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DOI：
10.1007/bf01644014
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发表时间：
1989-05-01
期刊：
影响因子：
7.5
通讯作者：
RAHMANZADEH, R
中科院分区：
文献类型：
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作者：
MEISSNER, A;HAAG, R;RAHMANZADEH, R
对60例慢性创伤后骨质疏松症患者进行了磷霉素辅助治疗的前瞻性临床研究。患者年龄17~78岁，平均37.4岁。慢性骨髓炎主要位于胫骨(43例)和股骨(13例)。分离出的病原菌主要为金黄色葡萄球菌(42%)、凝固酶阴性葡萄球菌(19%)、铜绿假单胞菌(12%)、链球菌(7%)和肠球菌(5%)。从骨髓性病灶分离出的病原菌对磷霉素敏感。对19例患者骨样中磷霉素浓度进行了测定。在最初接受5g磷霉素的患者组中，骨浓度在119.4至451.2毫克/L间质液体之间。在最初接受10g磷霉素治疗的患者中，骨浓度在117.1至3684.2毫克/L间质液体之间。其中金黄色葡萄球菌、大肠埃希菌2 mg/L，普通变形杆菌8 mg/L，A、B群链球菌32 mg/L，凝固酶阴性葡萄球菌、肠球菌、铜绿假单胞菌mg/L(金黄色葡萄球菌、大肠埃希菌2 mg/L，L变形杆菌8 mg/L，A、B群链球菌32 mg/L，凝固酶阴性葡萄球菌、肠球菌、铜绿假单胞菌mg/L)。在最短7个月和最长53个月(平均37个月)后评估治疗结果。结果：良54.7%，良3.8%，满意15.1%，不满意26.4%。
The therapeutic effectiveness of adjuvant therapy with fosfomycin was studied in a prospective clinical trial of 60 patients suffering from chronic posttraumatic osteolyelitits. The patients were aged between 17 and 78 years (mean 37.4 years). The chronic osteomyelitis was predominantly located in the tibia (43 patients) and in the femur (13 patients). Most of the pathogens isolated were Staphylococcus aureus (42%), coagulase-negative staphylococci (19%), Pseudomonas aeruginosa (12%), streptococci (7%) and enterococci (5%). The pathogens isolated froom the osteomyelitic foci were sensitive to fosfomycin. Fosfomycin concentrations in bone samples were determined in 19 patients. In the group of patients receiving initially 5 g fosfomycin, bone concentrations ranged between 119.4 and 451.2 mg/l of interstitial fluid. In the group of patients receiving intially 10 g fosfomycin, bone concentrations ranged between 117.1 and 3684.2 mg/l of interstitial fluid. The mean MIC90 values of the isolated pathogens ranged between 2 and 64 mg/l (S. aureus and Escherichia coli 2 mg/l, Proteus vulgaris 8 mg/l, streptococci groups A and B 32 mg/l and coagulase-negative staphylococci, enterococci and P. aeruginosa 64 mg/l) (S. aureus and Escherichia coli 2 mg/l, Proteus vulgaris 8mg/l, streptococci groups A and B 32 mg/l and coagulase-negative staphylococci, enterococci and P. aeruginosa 64 mg/l). The outcome of treatment was assessed after a minimum of seven and a maximum of 53 months (mean 37 months). The results were: very good 54.7%, good 3.8%, satisfactory 15.1% and unsatisfactory 26.4%.