Modelagem farmacocinética/farmacodinâmica do florfenicol para o tratamento da adenite equina por meio da simulação de Monte Carlo / Pharmacokinetic/pharmacodynamic modeling of florfenicol for the treatment of equine adenitis using Monte Carlo simulation

O objetivo deste trabalho foi avaliar a eficácia do florfenicol na dose usualmente empregada em equinos de 22 mg/kg pelas vias intravenosa, intramuscular e oral para o tratamento de adenite equina por Streptococcus equi. subsp. equi, usando a modelagem farmacocinética/farmacodinâmica (PK/PD – Pharmacokinetic/Pharmacodynamic) e a simulação de Monte Carlo. Foi realizada uma simulação de Monte Carlo a partir dos parâmetros PK, logo depois, efetuou-se a modelagem PK/PD para determinar as taxas de eficácia do antimicrobiano para o tratamento dessa infecção bacteriana, de acordo com o valor da concentração inibitória mínima (CIM), em um intervalo de CIM de 0,125 – 4 μg/mL. Pela via intravenosa, a probabilidade de erradicação bacteriana foi de 100% para CIM até 0,5 μg/mL e efeito bacteriostático com probabilidades de 99% e 80% para CIMs de 2 e 4 μg/mL, respectivamente. Já pelas vias intramuscular e oral a probabilidade de se atingir o índice de erradicação bacteriológica foi de 100% para CIM de até 0,5 μg/mL, contudo, atinge valores de 80% e 81%, respectivamente, para CIM de 1 μg/mL considerando o efeito bactericida (p<0,01). Portanto, através desse estudo é evidenciado a eficácia do florfenicol até a CIM de 0,5 μg/mL para as três vias de administração citadas, entretanto, para CIMs superiores a esse valor, é imprescindível o ajuste da dose farmacológica, evitando falhas na terapêutica e possível resistência microbiana.

The objective of this study was to evaluate the efficacy of florfenicol at the dose usually used in horses of 22 mg/kg by intravenous, intramuscular and oral routes for the treatment of equine adenitis caused by Streptococcus equi. subsp. equi, using Pharmacokinetic/Pharmacodynamic (PK/PD) modeling and Monte Carlo simulation. A Monte Carlo simulation was performed from the PK parameters, then PK/PD modeling was performed to determine the antimicrobial efficacy rates for the treatment of this bacterial infection, according to the minimum inhibitory concentration (MIC) value, in a MIC range of 0.125 - 4 μg/mL. Intravenously, the probability of bacterial eradication was 100% for MICs up to 0.5 μg/mL, and the bacteriostatic effect was 99% and 80% for MICs of 2 and 4 μg/mL, respectively. However, for the intramuscular and oral routes, the probability of reaching the bacteriologic eradication index was 100% for MICs of up to 0.5 μg/mL, however, it reaches values of 80% and 81%, respectively, for MICs of 1 μg/mL considering the bactericidal effect (p<0.01). Therefore, through this study the efficacy of florfenicol is evidenced up to the MIC of 0.5 μg/mL for the three routes of administration cited, however, for MICs higher than this value, it is essential to adjust the pharmacological dose, avoiding failures in therapy and possible microbial resistance.

Resistência de Neisseria gonorrhoeae a antimicrobianos na prática clínica: como está o Brasil? / Antimicrobials resistance of Neisseria gonorrhoeae in clinical practice: where Brazil stands?

Estima-se que um milhão de infecções sexualmente transmissíveis (IST) sejam adquiridas por dia no mundo, segundo a Organização Mundial da Saúde. Elas podem ser causadas por diversos micro-organismos pelo contato sexual. Embora tratáveis, as infecções, como a clamidiana, sífilis, tricomoníase e gonorreia, são responsáveis por 350 milhões de novos casos de IST anualmente no mundo. A gonorreia é a segunda IST bacteriana mais prevalente no planeta e tem chamado atenção nos últimos anos em decorrência da baixa eficácia em seu tratamento. O agente etiológico é a Neisseria gonorrhoeae. Na maioria das mulheres, a infecção por esse micro-organismo é assintomática, dificultando ainda mais seu diagnóstico e tratamento e, portanto, aumentando o risco de desenvolvimento de suas complicações associadas. Mesmo quando diagnosticada, essa infecção está sujeita a um alto índice de insucesso terapêutico que se deve, principalmente, à grande plasticidade genética da N. gonorrhoeae para aquisição de genes cromossômicos ou plasmidiais de resistência. O aumento da resistência desse micro-organismo a antimicrobianos comumente utilizados no tratamento, como penicilina, tetraciclina e ciprofloxacina, tem sido relatado em diversos países. No Brasil, poucos estudos estão disponíveis, mas em alguns estados já foram relatadas linhagens resistentes à ciprofloxacina. Dessa forma, deve-se ressaltar a importância de novos estudos que visem descrever o perfil da resistência da N. gonorrhoeae a antimicrobianos. Tais achados certamente nortearão a implementação de sistemas de vigilância epidemiológica no país visto que, até o momento, as infecções por N. gonorrhoeae sequer estão incluídas na lista nacional de doenças e agravos de notificação compulsória.(AU)

According to the World Health Organization, approximately one million sexually transmitted infections (STI) are acquired daily in the world. These infections can be caused by several microorganisms via contact. The treatable STI, such as chlamydia, syphilis, trichomoniasis and gonorrhea, account for 350 million new cases of STI each year worldwide. Gonorrhoea is caused by Neisseria gonorrhoeae and is the second most common bacterial STI in the world. It has drawn more attention in the last years due to the low efficacy in its treatment. Most women with this infection are asymptomatic, which makes its diagnosis and treatment troublesome increasing the risk for its associated complications. Even when diagnosed, this infection is subject to a high rate of therapeutic failure mainly due to the great genetic plasticity of N. gonorrhoeae for the acquisition of chromosomal or resistance plasmid enes. Increased resistance of this microorganism to antimicrobials commonly used in treatment such as penicillin, tetracycline and ciprofloxacin has been reported in several countries. In Brazil, few studies are available, but in some states strains resistant to ciprofloxacin were alreadyreported. The refore, it is important to highlight the importance of new studies aimed at describing the resistance profile of N. gonorrhoeae to antimicrobials in Brazil context. These findings will certainly guide the implementation of epidemiological surveillance systems in the country, since until now N. gonorrhoeae infections do not figure into the national list of compulsorily notifiable diseases.(AU)

Serotype and antimicrobial susceptibility of Actinobacillus pleuropneumoniae isolates from pigs in Korea / 대한수의학회지

Actinobacillus (A.) pleuropneumoniae is the causative agent of pleuropneumonia which is one of the most important respiratory diseases in pigs worldwide. A total of 32 A. pleuropneumoniae isolates from diseased pigs during 2008 to 2010 were serotyped by polymerase chain reaction method. The susceptibility of the isolates to 13 antimicrobial agents were determined by disk diffusion test. In all the 32 isolates examined in this study, serotype 5 (16 isolates: 50%), 1 (7 isolates: 21.9%), 2 (5 isolates: 15.6%) and 12 (1 isolate: 3.1%) were found. Of all tested antimicrobial agents, resistance to oxytetracycline was found in 96.9% of isolates, followed by resistance to amikacin (81.2%), neomycin (68.7%), kanamycin (53.1%), penicillin (50.0%), gentamicin (43.7%), florfenicol (25.0%), ampicillin (18.7%), colistin (9.4%), trimethoprim/sulfamethoxazole, ceftiofur (8.3%), amoxicillin/clavulanic acid (3.1%) and enrofloxacin (0%). Oxytetracycline or florfenicol-resistant isolates were examined for the presence of resistance gene. Among the 31 oxytetracycline-resistant isolates, tetB, tetH and tetO genes were detected in 22 (71%), 8 (26%) and 1 (3%) isolates, respectively. The floR genes were detected in 8 (100%) of the 8 florfenicol-resistant A. pleuropneumoniae isolates.

in vitro effect of chloramphenicol and salicylate on erythrocytes of patients with favism

Glucose 6-phosphate dehydrogenase [G6PD] deficiency is the most common of all clinically significant enzyme defects. A long list of drugs thought to cause haemolysis in patients with this enzyme defect. To determine whether chloramphenicol and salicylate can act as in vitro exogenous oxidizing agents and subsequently cause haemolysis of G6PD deficient erythrocytes and matching the result with the data obtained from the clinical observations which includes the intake of trimethoprim-sulfamethoxazole, salicylate or nalidixic acid by favic patient. Sixty six patients admitted to the hospital [Karbala teaching hospital for Children, Karbala, Iraq] with history of sudden onset of pallor and dark urine after fava beans ingestion were studied. Each patient was fully examined and his parents were asked about the type of fava beans ingested and the past drug history. Of the sixty six patients, ten were evaluated 1-3 months later and blood samples were taken from them along with blood samples from ten healthy volunteers. Blood samples from both groups were incubated in vitro with chloramphenicol and salicylate separately. Mean [SD] of methaemoglobin concentrations at baseline and after incubation with therapeutic and toxic concentrations of chloramphenicol [15 micro g/ml and 25 micro g/ml] and salicylate [150 micro g/ml and 300 micro g/ml] were calculated for both the control and the study groups. Paired t-test showed no significant differences [P> 0.05] in methaemoglobin concentrations at baseline and after incubation with therapeutic and toxic concentrations of these drugs. Mean percentage differences from baseline for G6PD deficient group were not significantly different from control group at both concentrations of these drugs as tested by student t-test. Hemolysis in G[6]PD deficient patients occurs mainly after fresh fava beans ingestion. chloramphenicol and acetylsalicylic acid do not cause significant hemolysis in G[6]PD deficient erythrocytes in vitro

A comparative study of single-dose treatment of chancroid using thiamphenicol versus Azithromycin

A study was conducted in São Paulo, Brazil, to compare azithromycin with thiamphenicol for the single-dose treatment of chancroid. In all, 54 men with chancroid were tested. The etiology was determined by clinical characterization and direct bacterioscopy with Gram staining. None of the patients had positive serology or dark-field examination indicating active infection with Treponema pallidum. Genital infections due to Neisseria gonorrhoeae and herpes simplex virus were excluded by polymerase chain reaction testing. For 54 patients with chancroid, cure rates with single-dose treatment were 73 percent with azithromycin and 89 percent with thiamphenicol. HIV seropositivity was found to be associated with treatment failure (p=0.001). The treatment failed in all HIV positive patients treated with azithromycin (p=0.002) and this drug should be avoided in these co-infected patients. In the view of the authors, thiamphenicol is the most indicated single-dose regimen for chancroid treatment.

Biological compatibility of the endodontic paste prepared with tetracycline, thiamphenicol and zinc oxide implanted on the subcutaneous tissue of rats / Compatibilidad biológica de pasta endodóntica preparada con tetraciclina,tiamfenicol y óxido de zinc, implantado en el tejido subcutáneo de ratas

An important requirement for endodontic paste with antibiotics placed in direct contact with living tissues is biocompatibility. The aim of this study was to evaluate the paste biocompatibility prepared with zinc oxide (1.25mg), tetracycline (8mg) and thiamphenicol (26.67mg). The paste and its components were implanted separately through polyethylene sterile tubes of 10mm in length and 1.3mm in diameter, in the subcutaneous tissue of rats with the experiment control at intervals of 3, 7, 15 and 30 days. Each day 6 rats were used, being 3 of them with implant of the substances in four sites placed on the back of the animals and 3 sham animals where it was implanted the polyethylene empty tubes. The experimental animals were anesthetized in an intra-peritoneal way with ketamina and xilazina (0.75ml / g body weight). After the experimental periods, the animals were anesthetized with the same anesthetic overdose. It was held an excision biopsy of the implant area with 10 mm to the security limit included in paraffin following a plan of random histological cut and uniformlyisotropic or oriented cuts according to stereological principles, getting a statistical estimative of the relative amount of inflammatory cells or not on the test system, getting as a result the paste biocompatibility, being the zinc oxide the most toxic element for the cell quality found.

Un requisito importante para la pasta endodóntica preparada con antibióticos, que es colocada en contacto directo con los tejidos vivos es la biocompatibilidad. El objetivo de este estudio fue evaluar la biocompatibilidad de la pasta preparada con óxido del zinc (1,25mg), tetraciclina (8mg) y el tiamfenicol (26,67mg). La pasta y sus componentes fueron implantados por separado a través de tubos estériles de polietileno de 10 mm de longitud y de 1,3mm de diámetro en el tejido subcutáneo de ratas en intervalos de 3, 7, 15 y 30 días. Cada día, 6 ratas fueron implantadas en cuatro sitios ubicados en la parte posterior de los animales, 3 de ellas con el implante de las sustancias y 3 fueron implantados con los tubos de polietileno vacíos. Los animales del experimento fueron anestesiados intraperitteonealmen, con ketamina y xilasina (0,75 ml/g peso corporal). Después de los periodos experimentales, los animales fueron anestesiados con la misma sobredosis anestésica. Fue realizada una biopsia exisional del área del implante con 10 mm de límite de seguridad, luego se realizaron cortes histológico al azar uniformemente isotrópicos o orientados según los principios esteriológicos, consiguiendo un estimativo estadístico de la cantidad relativa de células inflamatorias en el sistema de prueba. Se obtuvieron resultados de la biocompatibilidad de la pasta, siendo el óxido del zinc el elemento mas tóxico según la cualidad de las células que fueron encontradas.

Donovanosis treated with thiamphenicol

Ten patients with donovanosis were treated with thiamphenicol for two weeks. In eight of them, included two HIV infected patients, lesions healed. The safety profile of thiamphenicol makes it a useful and cost-effective agent in the management of donovanosis. Randomized controlled trials should be conducted with these treatment options.

Antimicrobial susceptibility and molecular detection of chloramphenicol and florfenicol resistance among Escherichia coli isolates from diseased chickens

Seventy Escherichia coli isolates recovered from diseasedchickens diagnosed with colibacillosis in Henan Province,China, between 2004 and 2005 were characterized forantimicrobial susceptibility profiles via a broth doublingdilution method. Overall, the isolates displayed resistanceto trimethoprim-sulfamethoxazole (100%), oxytetracycline(100%), ampicillin (83%), enrofloxacin (83%), and ciprofloxacin(81%), respectively. Among the phenicols, resistance wasapproximately 79% and 29% for chloramphenicol andflorfenicol, respectively. Molecular detection revealed thatthe incidence rates of the floR, cmlA, cat1, cat2 and cat3were 29, 31, 16, 13, and 0%, respectively. Additionally,10% of the isolates were positive for both floR and cmlA.As these antimicrobial agents may potentially inducecross-resistance between animal and human bacterialpathogens, their prudent use in veterinary medicine ishighly recommended.

Thiamphenicol in the treatment of chancroid: a study of 1.128 cases

Thiamphenicol, an aminic derivate of hydrocarbilsulfonil propandiol, was used for the treatment of 1,171 chancroid bearing patients. Each patient was medicated with 5.0 g of granulated thiamphenicol, orally, in a single dose, and was reevaluated 3, 7 and 10 days after the treatment. Ten patients (0.89 percent) did not respond to the proposed treatment. 133 patients presented healed ulcers after 3 days of treatment, 976 patients healed chancres on the seventh day after the treatment, and 39 patients took 10 days to present healed chancres. The results of this study indicate that the rate of patients that were cured, the low incidence of side effects, and the practicality of administration make of thiamphenicol an excellent choice for the treatment of chancroid.

Farmacocinética y eficacia clínica del tianfenicol en pollo de engorda / Pharmacokinetic and clinical efficacy of thiamphenicol in poultry

Se determinaron las variables farmacocinéticas y la eficacia clínica del tianfenicol (TF) en pollo de engorda, para lo cual se utilizaron 60 pollos Arbor Acress de 500 g de peso corporal, divididos en tres grupos: Grupo 1, al que se le administró una dosis bolo única de 20 mg/kg de TF vía intravenosa, para obtener muestras sanguíneas a diferentes tiempos, y determinar la concentración sérica del TF por el método microbiológico de Bennet. Al segundo grupo se le administró TF en el alimento (20 mg/kg), y el tercer grupo recibió TF en el agua de bebida a razón de 400 ppm (20mg/kg). En la fase clínica, se utilizaron brotes clínicos de la enfermedad crónica respiratoria complicada por Escherichia coli y Mycoplasma en tres casetas de 49 000 pollos cada una, de tres semanas de edad, a los que se trató con TF en el agua de bebida de manera comparativa con otros antibacterianos; se estimó la ganancia de peso, conversión alimentaria y análisis de supervivencia. Los resultados revelaron que el TF posee un excelente volumen de distribución 2.8 1/kg, con una Cpmax de 28.8 m g/mL en el grupo medicado en el agua de bebida, y de 9.7 m g/mL el del alimento. En relación con su eficacia, ésta fue favorable al TF, sin haber diferencias significativas en las variables productivas respecto de los otros antibacterianos; por lo que se postula al TF como una excelente alternativa para la avicultura nacional.

Septic Hip in a Child due to H.influenzae: Problems with a Recent Experience / 대한정형외과학회잡지

We report a case of acute septic arthritis of the hip in a child due to H. influenzae with review of the problems encountered. A one year and 9 months-old male child was admitted because of fever, limping and restlessness of 48-hour duration. Under the impression of septic arthritis of the right hip, blind broad-spectrum antibiotic regimen was initially instituted. Fever subsided immediately and two blood cultures yielded no growth, as did joint tapping. But fever recurred on the 8th day of admission. MRI demonstrated fluid collection in the right hip. Arthrotomy yielded thin pus. The antibiotic regimen was shifted to vancomycin, according to the culture report of S. aureus. However, spiking fever continued. On the 4th week of admission, recheck MRI demonstrated fluid collection in and out of the hip joint. A second arthrotomy yielded frank pus. H. influenzae was reported in pus culture for the first time, being susceptive only to chloramphenicol. Fever was down to normal temperature after injection of urfamycin. Radiograph on the 17th day after the 2nd arthrotomy revealed posterior dislocation of the right hip. MRI demonstrated granulation tissue within the acetabulum. Open reduction confirmed granulation tissue without pus. This case suggests: 1. Routine blind antibiotic regimen for gram-positive and negative organisms in the initial phase of treatment may fail in the rare case of H. influenzae. This may lead the surgeon to miss the optimum time of surgical intervention despite early diagnosis, 2. Arthrotomy may fail if not followed by antibiotics sensitive to the pathogen. 3. Delayed pathologic dislocation may ensue due to invasion of granulation tissue.

Vaginose bacteriana: experiência com o tiafenicol / Bacterial vaginosis: experience with thiamphenicol; \"Clue Cell\"

O objetivo deste trablho foi avaliar a eficácia do tiafenicol no tratamento da vaginose bacteriana. Foram estudadas 31 pacientes portadoras de vaginose bacteriana, cujo diagnóstico presuntivo foi confirmado através do isolamento de Gardneella vaginalis no conteúdo vaginal. Realizou-se também cultura para germes aeróbios, anaeróbios, Chlamydia trachomatis, Neisseria gonorrhoeae e Mobiluncus sp. As pacientes e seus parceiros sexuais foram tratados com tiafenicol, na dosagem de 2,5 g VO (dose única, ao dia, durante dois dias). As avaliaçÆes realizadas no 7§ e 28§ dias após o tratamento demonstraram cura clínica em 29 (93,5 por cento) casos. A cultura para Gardnerella vaginalis foi positiva em dois (6,5 por cento) casos no 7§ dia e em três (9,7 por cento) casos no 28§ dia. Os germes anaeróbios foram isolados em um (3,2 por cento) caso no 7§ dia e em dois (6,5 por cento) casos no 28§ dia. A cultura para Mobiluncus sp foi positiva em seis (19,3 por cento) casos antes do tratamento e negativa em todos após omesmo. Concluem os autores que otiafenicol mostrou-se eficaz para otratamento da vaginose bacteriana

Estudo multicêntrico comparativo da eficácia da eritromicina, do sulfametoxazol + trimetoprima, tianfenicol cápsulas e tianfenicol granulado no tratamento do cancro mole / Multicentric comparative study of the efficacy of erytromycin, sulfamethoxazole + trimetroprim, thianphenicol capsules and thianphenicol granules in treatment of chancroid

Säo comparados os resultados terapêuticos obtidos em estudo multicêntrico, randomizado, de 4 grupos de 15 pacientes portadores de cancro mole que procuraram espontaneamente quatro centros especializados em doenças sexualmente transmissíveis localizados em diferentes estados do Brasil e que, por randomizaçäo, foram tratados com um entre os quatro esquemas de tratamento especificados a seguir: eritromicina 500mg 6/6 horas- 10dias; sulfametoxazol+trimetoprima 960mg 12/12 horas-10 dias; tianfenicol 5,0g dose única e tianfenicaol 500mg 8/8 horas-cinco dias. O diagnóstico laboratorial baseou-se na bacterioscopia; o primeiro controle ocorreu no quinto dia e a avaliaçäo final no décimo quinto dia. A eritromicina foi eficaz em 86 por cento dos casos, o sulfametoxazol+trimetoprima em 80 por cento, e o trianfenicol, cápsulas e granulado, em 93 por cento. Os resultados obtidos permitem concluir que os medicamentos utilizados constituem opçäo no tratamento do controle do cancro mole

Mobiluncus sp e seu tratamento pelo tiamfenicol / Mobiluncus' treatment by thiaphenicol

Os autores estudaram 200 pacientes com vaginose sendo diagnosticados 85 casos de Mobiluncus (42,50 por cento). As pacientes tinham a idade entre 20 a 50 anos, 35 casadas, 50 näo casadas; 21 eram brancas; 64 näo brancas e 57, multíparas. Estas pacientes apresentaram os seguintes sintomas: fluxo vaginal (38,82 por cento), ausência de fluxo (14,11 por cento), odor fétido (100,00 por cento), prurido (21,17 por cento), ardência (14,11 por cento). Os autores usaram o Tiamfenicol granulado 2,5 g por dia, durante quatro dias. Observaram a cura de 92,94 por cento das pacientes e falha em 7,06 por cento. O Tiamfenicol provou ser efetivo e seguro para o tratamento do Mobiluncus. Näo se observaram efeitos colaterais.

Avaliacao de uma nova classificacao do risco de contaminacao em procedimentos obstetricos / Evaluation of a new classification of contamination risk for obstetric procedures

Foram comparadas duas formas de administracao de antibioticos, orientadas por duas classificacoes distintas do risco de contaminacao em procedimentos obstetricos. O estudo inclui 3347 pacientes submetidas a procedimentos obstetricos durante o ano de 1990. Observou-se uma reducao significativa do indice de infeccao puerperal de 6,72 para 2,59 por cento com a introducao de uma classificacao mais rigorosa do risco de contaminacao e de antibioticoterapia profilatica. Os autores concluem que a utilizacao profilatica de antibioticos orientada por uma classificacao rigorosa do risco de contaminacao em procedimentos obstetricos foi eficiente na reducao do indice de infeccao puerperal.

Determination of chloramphenicol and thiamphenicol in the presence of their degradation products using first derivative spectrophotometry

A method is presented for the determination of chloramphenicol and thiamphenicol in the presence of their degradation products using first derivative spectrophotometry by measuring the absolute value of the first derivative curves at the zero contribution of the corresponding degradation products, the concentration of the intact drug can be calculated directly without interference of the degradation product. The method was proved using laboratory prepared mixtures of the intact drugs with their degradation products

Tianfenicol no tratamento das infecçöes näo complicadas dos órgäos genitais inferiores na mulher / Thiamphenicol in the treatment of not complicated infections of the lower genital tract of women

A eficácia do Tianfenicol foi avaliada em 25 mulheres, acometidas por infecçöes dos órgäos genitais inferiores, que procuravam o centro OMS-DST do Instituto Alfred Fournier, Paris. Na maioria dos casos tratava-se de pacientes assintomáticas, encaminhadas pelos parceiros masculinos portadores da infecçäo; nos outros casos constatou-se leucorréia, prurido vulvar, vulvovaginite, exocervicite, edema vulvar e/ou cistite com dispareunia. O tratamento foi constituído por Tianfenicol 2,5g, de 12/12 horas, no primeiro dia e, a seguir, 500mg de 8/8 horas durante 20 dias. Houve negativaçäo das culturas, realizadas em célula McCoy, em 88% dos casos. Pelas observaçöes efetuadas, inclusive pela excelente tolerabilidade, o Tianfenicol constitui-se na terapêutica de escolha para o tratamento das infecçöes genitais baixas näo complicadas por Chlamydia trachomatis

Tratamento da donovanose com o tianfenicol / Treatment of donovanosis with thiamphenicol

Säo apresentados os resultados terapêuticos obtidos no tratamento de 34 pacientes portadores de donovanose, atendidos na Clínica Dermatológica da Universidade Federal de Pernambuco, Os pacientes foram tratados com tianfenicol na seguinte posologia: 2,5g sob forma de granulado, no primeiro dia e, a seguir, 500 mg de 12/12 horas até o desaparecimento das lesöes e a negativaçäo bacteriológica. Esta foi obtida em 82,4% dos pacientes a partir da segunda semana e em 100% na terceira semana de tratamento. Näo foram observados efeitos colaterais significativos ou intolerância a droga