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发展的方法对抗生素治疗的儿科脊髓异性脊髓炎
Doron Mulla1, Yoel Levinsky1, Nufar Marcus1
1Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
The Journal of pediatrics
|July 11, 2024
概括
从静脉注射到口服抗生素过渡的脊髓瘤炎儿科患者早期缩短了住院时间和治疗时间. 这种方法在临床上是适当的,减少并发症没有显著的负面影响.
科学领域:
- 儿童传染病 儿童传染病
- 儿科整形外科 儿科整形外科
- 临床微生物学 临床微生物学
背景情况:
- 脊椎间脊髓炎 (IS) 是一种严重的感染,影响儿童的脊椎.
- 目前的治疗通常涉及长时间的静脉注射 (IV) 抗生素治疗.
- 优化治疗持续时间可以改善患者的治疗结果和资源利用率.
研究的目的:
- 描述儿科胸部和腰部脊椎间脊椎脊髓炎的临床特征.
- 评估从延长时间的静脉注射抗生素过渡到较短,临床指导的静脉注射到口服治疗方案的影响.
- 评估与不同治疗持续时间相关的临床结果和并发症.
主要方法:
- 对124名儿科患者 (0-18岁) 的回顾性研究,成像证实胸部和腰部IS (2000-2022年).
- 患者接受较长的IV抗生素疗程与接受较短,临床指导的IV-to-oral疗程的患者之间的比较.
- 分析临床症状,实验室发现 (ESR,CRP),住院时间和治疗并发症.
主要成果:
- 常见的症状包括尿布更换时的易怒和疼痛;升高的ESR是最常见的实验室发现 (95%).
- 实施较短的IV-to-oral治疗方案显著减少了医院住院时间的中位数,从12天减少到8天 (P=.008),IV治疗时间从14天减少到8天 (P<.001).
- 只有1.6%的短期治疗组需要重新住院,而长时间的静脉注射治疗与7.3%的患者的并发症有关.
结论:
- 早期过渡到口服抗生素治疗儿科脊髓炎是临床上适当的.
- 这种方法有效地缩短了住院和静脉注射抗生素的持续时间.
- 修改后的治疗策略显示出最小的负面临床影响,并减少了与治疗相关的并发症.
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