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Padiatr Padol. 1989;24(1):21-32.

[Resistance of staphylococci to intracellular killing by macrophages--a new pathophysiologic concept of acute hematogenous osteomyelitis in childhood and its therapeutic consequences].

[Article in German]

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Universit├Ąts-Kinderklinik, Innsbruck.


The pathophysiologic mechanism of acute hematogenous osteomyelitis in children has been further elucidated. Investigations revealed, that certain strains of staphylococcus aureus, responsible for the majority of infections, can resist intracellular killing after phagocytosis. Beta-lactam-antibiotics don't penetrate well into phagocytes and are unable to eradicate staphylococci surviving intracellularly. Fosfomycin, clindamycin and combinations of these antibiotics with beta-lactam-antibiotics are able to eradicate staphylococci also in phagocytic vacuoles. In a therapeutic investigation 36 patients have been treated with fosfomycin in combination with cefamandole intravenously for 10-14 days followed by clindamycin orally for 3-6 weeks. With this treatment schedule the therapeutic outcome was superior to previously employed therapeutic regimen.

[Indexed for MEDLINE]

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