Modernas cefalosporinas en el tratamiento de la osteomielitis humana

Abstract

In the last 2 decades, very significative changes in the knowlege of bone infections, have taken place, coinciding with the increase of ita occurrence. S. aureus is the most frequent pathogen identified, but altogether, gramnegative badilli are most usual isolates, specially iii post-traumatic and postsurgical, conti guous osteomyelitis, with chronic evolution and nos ocomial development. The frequency of polymicrobial infection oscillates between 30-60%, participating grampositive and gramnegative, aerobic and anaerobic, cocci and bacilli. Treatment of bone infections oblige tu perform with phannacodynamic and pharmacoki netic criterios. Moderas céphalosporins of 3” genera fon, developed specially iii the 1980s, are by ita activity, meehanism of action, permanency and stabi lity in the infected bone, likely drugs very useful for the treatnient of osteomyelitis. We present our expe rience with 110 patients treated with cefotaxime (50 cases), considered model cephalosporin iii this group; ceftazidime (30 cases), by ita antipseudomonal activity and ceftriaxone (30 cases), by ita acceptable pharma cokinetics, which perniited us only daily dose IV or IM. With all of them, and sensitive microorganisms and proper surgery, we obtained success with percen tage greater 80% with a follow-up of 6 months.