三甲-硫甲醇治疗儿科骨关节感染的治疗方法
Lauren M McDaniel1, Suiyini Fiawoo2, Pranita D Tamma2
1Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Washington, USA.
Journal of the Pediatric Infectious Diseases Society
|September 27, 2023
概括
特里梅托普林-硫法米托克萨 (TMP-SMX) 与儿童骨关节感染的其他抗生素相比,显示了类似的临床失败率,但与其他抗生素相比,不良事件更多. 这表明需要仔细考虑TMP-SMX用于治疗这些严重的儿童骨和关节感染.
科学领域:
- 儿童传染病 儿童传染病
- 药理学和治疗学 药理学和治疗学
- 临床有效性研究研究 临床有效性研究
背景情况:
- 三甲-硫甲醇 (TMP-SMX) 具有针对金黄色葡萄球菌 (Staphylococcus aureus) 的广泛活性.
- 然而,它在儿科骨关节感染中的应用仍然有限.
- 这项研究调查了其在这个人群中的比较有效性和安全性.
研究的目的:
- 为了比较TMP-SMX与其他抗生素治疗方案的有效性,用于急性儿科骨关节感染.
- 为了评估与TMP-SMX治疗的儿童与替代品治疗的抗生素相关不良事件 (AE) 的发生率.
主要方法:
- 一项涉及2016-2021年住院儿科患者 (≤18岁) 的比较疗效研究.
- 使用了对治疗的逆概率加权倾向性得分分析.
- 主要结局:治疗失败 (综合终点);次要结局:与抗生素相关的副作用,均在治疗后6个月内发生.
主要成果:
- 分析了116名患者;26人接受了TMP-SMX,90人接受了其他抗生素 (克林达米辛,万科米辛,塞法佐林).
- 没有观察到治疗失败率 (43%对19%) 的显著差异.
- 使用TMP-SMX与更高的非计划ED/门诊访问和整体AE的发病率相关 (41%对19%,P=0.012).
结论:
- TMP-SMX与儿科骨关节感染的临床失败增加无关.
- 然而,与替代抗生素选择相比,TMP-SMX治疗与更高的不良事件率有关.
- 这些发现表明,在考虑TMP-SMX用于儿科骨关节感染时,需要仔细评估风险和益处.
相关概念视频
01:27Combined Effects of Drugs: Synergism
4.0K
Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Such synergistic combinations...
4.0K
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
14
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
14
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
15
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
15
01:26Urine Studies II: Urine Culture and Sensitivity Test
38
A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
38
01:26Tonsillitis II: Management
131
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
131
01:17Urinary Tract Infection IV: Nursing Management
18
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
18