346Vol.31,No.4Feb.2023中国矫形外科杂志OrthopedicJournalofChina第31卷第4期2023年2月·综述·儿童急性血源性骨髓炎全身抗生素治疗邸佳琛1，2，时培晟1，高秋明1*（1.解放军联勤保障部队第九四〇医院创伤骨科，甘肃兰州730050；2.甘肃中医药大学第一临床医学院，甘肃兰州730000）摘要：急性血源性骨髓炎（acutehematogenousosteomyelitis,AHO）是儿童骨关节感染中最常见的类型之一。及时准确的诊断和早期有效的抗菌治疗是获得良好预后的关键。抗生素的合理使用在该病的治疗中扮演着重要角色。有关抗生素的选择、给药方式及用药疗程等方面，需根据当地的流行病学及耐药模式、疾病的严重程度、致病菌毒力、患儿的基础疾病与免疫状态及其对治疗的反应等诸多因素进行个体化制定。此外，在过去的十几年里，该病的流行病学发生了迅速变化，特别是耐甲氧西林金黄色葡萄球菌（methicillin-resistantStaphylococcusaureus,MRSA）引起的感染，对治疗提出了新的挑战。关键词：骨髓炎，儿科，抗生素，治疗，耐甲氧西林金黄色葡萄球菌中图分类号：R681.2文献标志码：A文章编号：1005-8478（2023）04-0346-05Systemicantibiotictreatmentforacutehematogenousosteomyelitisinchildren//DIJia-chen1,2,SHIPei-sheng1,GAOQiu-ming1.1.DepartmentofTraumaticOrthopedics,The940thHospital,JointLogisticSupportForceofPLA,Lanzhou730050,China;2.FirstClinicalMedicalCollege,GansuUniversityofChineseMedicine,Lanzhou730000,ChinaAbstract:Acutehematogenousosteomyelitis(AHO)isoneofthemostcommontypesofboneandjointinfectioninchildren,whichshouldbeaccuratelydiagnosedontimeandtreatedearlywitheffectiveantibacterialdrugstoachievegoodprognosis.Therationaluseofan⁃tibioticsplaysanimportantroleinthetreatmentofthisdisease.Thechoiceofantibiotics,themodeofadministrationandthecourseoftreat⁃mentshouldbeindividualizedaccordingtothelocalepidemiologyanddrugresistancemodel,theseverityofthedisease,thevirulenceofpathogenicbacteria,theunderlyingdiseasesandimmunityofchildrenandtheirresponsetotreatment.Inaddition,theepidemiologyofthediseasehaschangedrapidlyinthepastdecade,especiallytheinfectioncausedbymethicillin-resistantStaphylococcusaureus(MRSA),whichposesanewchallengetothetreatment.Keywords:osteomyelitis,ped...
