ABSTRACT

Introduction

Fosfomycin is a wide spectrum bactericidal antibiotic with a unique mode of action, low toxicity, and good penetration in tissues with deep-seated infections, including bone and joint infections.

Areas covered

Data were extracted from 19 published articles. Three hundred and sixty-five patients, with broad age range, received intravenous fosfomycin for the treatment of bone and joint infections (including arthritis, acute and chronic osteomyelitis, discitis, periprosthetic joint infection). Fosfomycin was given as part of a combination antimicrobial therapy in the majority of patients (93.7%). The dosage of fosfomycin ranged from 4 g/day (in one case) to 24 g/day. The dosage of fosfomycin, in some cases, mostly pediatric, was calculated based on body weight, ranging from 50 mg/kg/day to 250 mg/kg/day. The duration of fosfomycin treatment ranged from a couple of days up to 3 months. The most common isolated pathogen was Staphylococcus aureus (38.9%). Three hundred patients (82.2%) were successfully treated. Fosfomycin was well tolerated, as few patients developed mild adverse events, mostly gastrointestinal discomfort, hypernatremia, skin rash, and neutropenia.

Expert opinion

The available data suggests that intravenous fosfomycin may be beneficial for the treatment of patients with bone and joint infections, especially when used as part of a combination antibiotic regimen.

中文翻译：

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静脉注射磷霉素治疗骨关节感染：综述

摘要

介绍

磷霉素是一种广谱杀菌抗生素，具有独特的作用方式、低毒性和对深部感染（包括骨和关节感染）组织的良好渗透性。

涵盖的领域

数据来自 19 篇已发表的文章。365 名年龄范围广泛的患者接受了静脉注射磷霉素治疗骨和关节感染（包括关节炎、急慢性骨髓炎、椎间盘炎、假体周围感染）。大多数患者（93.7%）将磷霉素作为联合抗菌治疗的一部分。磷霉素的剂量范围为 4 克/天（在一种情况下）至 24 克/天。磷霉素的剂量，在某些情况下，主要是儿科，是根据体重计算的，从 50 mg/kg/天到 250 mg/kg/天不等。磷霉素治疗的持续时间从几天到三个月不等。最常见的分离病原体是金黄色葡萄球菌(38.9%)。300名患者（82.2%）成功治疗。磷霉素耐受性良好，因为很少有患者出现轻度不良事件，主要是胃肠道不适、高钠血症、皮疹和中性粒细胞减少症。

专家意见

现有数据表明，静脉注射磷霉素可能有益于骨和关节感染患者的治疗，尤其是作为联合抗生素方案的一部分时。