José Wagner de Barros; Constantino Jorge Calapodopulos; Décio José Oliveira; Paulo Miki Júnior
RESUMO
Entre 1986 e 1990, sessenta pacientes com osteomielite crônica foram tratados cirúrgica e quimioterapicamente sendo reavaliados, tanto no aspecto clínico como radiológico, num espaço de tempo de doze a sessenta meses. O tratamento cirúrgico foi associado à quimioterapia por sulfametoxazol e trimetoprim, por via oral, durante seis meses. O resultado foi considerado bom quando houve desaparecimento dos sinais e sintomas do processo infeccioso. Isto ocorreu em 50 (83,33%) pacientes submetidos a uma única intervenção cirúrgica e em 9 (15%) submetidos amais de uma cirurgia. Em um (1,67%) caso a osteomielite não foi debelada.
Palavras-chave: Osteomielite. Osteomielite crônica. Quimioterapia em osteomielite. Tratamento das osteomielites crônicas. Tratamento cirúrgico das osteomielites.
ABSTRACT
From 1986 to 1990, sixty patients were treated for chronic osteomyelitis with surgery and chemotherapy. The clinical and radiologic follow-ups ranged from twelve to sixty months. The surgery was associated with a six-month oral sulfamethoxazole-trimethoprim combination chemotherapy. Clinical cure was achieved when inflammatory signs and symptoms disappeared, as happened to 50 (83.33%) of the single surgery cases, and to 9 (15%) of the multiple surgery cases. For one case (1.67%) osteomyelitis was not cured.
Keywords: Osteomylitis. Chronic osteomyelitis. Chemotherapy for osteomyelitis. Chronic osteomylitis treatment. Surgery for osteomyelitis.
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REFERÊNCIAS BIBLIOGRÁFICAS
1. Barr AL, Whineray M. Immune thrombocytopenia induced by cotrimoxazole. Austrie Journal Medical 10:54-55, 1980. [ Links ]
2. Bell S. Further observations on the value of oral penicillin on chronic staphylococcal osteomyelitis. Austrie Medical Journal 2:591-593, 1976. [ Links ]
3. Black J, Hunt TL, Godley PJ. Oral antimicrobial therapy foradults with osteomyelitis or septic arthritis. Journal Infectious Disease 155:968-972, 1987. [ Links ]
4. Burchall JJ. Mechanism of action of trimethoprim- sulfamethoxazole. II. Journal Infectious Disease 128:437-441, 1973. [ Links ]
5. Bushdy SRM. Trimethoprim-sulfamethoxazole: In vitro microbiological aspects. Journal Infectious Disease 128: 442-462, 1973. [ Links ]
6. Dukes MNG. Meyler’s sideeffects ofdrugs. Elsevier, Amsterdam, 1988. [ Links ]
7. Dunkle LM, Brock N. Long-term follow-up of ambulatory management of osteomyelitis. Clinics Pediatrics 21:650-654, 1982. [ Links ]
8. Eisenberg J, Kitz D. Savings from out patient antibiotic therapy for osteomyelitis. Economic analysis of a therapeutic strategy. The Journal of the Americam Medical Association 255:1584-1588, 1986. [ Links ]
9. Foltzer MA, Reese RE. Trimethoprim- sulfamethoxazole and other sulfonamides. Medical Clinics North America 71:1177-1194, 1987. [ Links ]
10. HitchingsGH. Mechanism of action of trimethoprim- sulfamethoxazole. I. Journal Infectious Disease 128:433-436, 1973. [ Links ]
11. Kelly PJ, Fitzgerald Jr R. Results of treatment of tibial and femoral osteomyelitis in adults. Clinical Orthopaedics and Related Research 259:295-303, 1990. [ Links ]
12. Kucers A, Bennett NM. The use of antibiotics, JB Lippincott Company, Philadelphia, 1987. [ Links ]
13. Lemos C, Raso P. Ossos e articulações. In: Lopes ER, Chapadeiro E, Raso P, Tafuri WL (ed). Bogliolo Patologia. 4. edição. Guanabara Koogan, Rio de Janeiro p.812-854, 1987. [ Links ]
14. McEvoy GK. AHFS drug information 1990. Bethesda. American Society of Hospital Pharmacists, 1990. [ Links ]
15. Norden CW. Osteomyelitis. In: Mandel GL, Douglas RG, Benett JE (ed). Principles and practice of infectious disease. 3. edição. Churchill Livingstone, London p.922-930, 1990. [ Links ]
16. Papineau LJ, Alfageme A, Delcourt IP, Pilon L. Osteomyelitis chronique: excision et greffe de spongieux a l’air libre après mises a plat extensives. International Orthopedie 3:165-176, 1979. [ Links ]
17. Stiefelod SM, Graziani AL, MacGregor RR, Esterhai JL. Toxicities of antimicrobial agents used to treat osteomyelitis. Orthopedic Clinics North America 22:439-465, 1991. [ Links ]
18. Volpon JB. Osteomielite. Revista Brasileira Clínica Terapêutica 13:258-263, 1984. [ Links ]
Endereço para correspondência:
Dr. José Wagner de Barros.
Disciplina de Ortopedia e Traumatologia/HE/FMTM
Av. Getúlio Guaritá 130
38025-440
Uberaba, MG.
Recebido para publicação em 17/8/92.
Disciplina de Ortopedia e Traumatologia da Faculdade de Medicina do Triângulo Mineiro (FMTM), Uberaba, MG.
