ABSTRACT
Llevamos a cabo un estudio prospectivo, aleatorizado y abierto para evaluar la eficacia y la tolerabilidad de cefepima en el tratamiento de la osteomielitis por bacilos gramnegativos. Se incluyeron en el estudio pacientes hospitalizados con diagnóstico de osteomielitis por bacilos gramnegativos sensibles a cefepima. La cefepima se administró por vía intravenosa o intramuscular (2 g cada 8 o 12 horas). Los microorganismos fueron considerados sensibles a la cefepima cuando la CMI era <8 mg/ml. Se incluyeron 45 pacientes con infección osea, 43 con osteomielitis (22 crónicas y 21 agudas) y dos con artritis. En el análisis por protocolo se evaluaron 42 pacientes, de los cuales 30 (71,4 por ciento) curaron. Por intención de tratar se evaluaron 45 pacientes y de ellos curaron 33 (73,3 por ciento). Nuestro estudio sugiere que la cefepima es tan eficaz como otros modernos betalactámicos parenterales en el tratamiento de la osteomielitis por bacilos gramnegativos (AU)
Subject(s)
Middle Aged , Adult , Aged, 80 and over , Aged , Male , Female , Humans , Patient Selection , Osteomyelitis , Cephalosporins , Chronic Disease , Acute Disease , Gram-Negative Bacterial InfectionsABSTRACT
We conducted a prospective, randomized, open-label trial to evaluate the efficacy and tolerability of cefepime in the treatment of osteomyelitis caused by Gram-negative bacilli. Hospitalized patients with diagnosis of osteomyelitis due to Gram-negative bacilli susceptible to cefepime were elegible for enrollment. Cefepime was administered intravenously or intramuscularly (2 g every 8 or 12 hours). Microorganisms were considered susceptible to cefepime when the MIC was <8 mg/l. Forty-five patients with bone infections were enrolled, forty-three with osteomyelitis (22 chronic and 21 acute) and two with arthritis. In the per protocol analysis 42 patients were evaluated: 30 (71.4%) were cured. In the intent to treat analysis 45 patients were evaluated: 33 (73.3%) were cured. Our trial suggests that cefepime is as effective as other modern parenteral beta-lactam antibiotics in the treatment of osteomyelitis due to Gram-negative bacilli.