Perfil clínico e desfecho de tratamento de pacientes com osteomielite no Hospital Universitário de Lagarto (HUL)

Abstract

Introduction Osteomyelitis is an infection, mostly resulting from fractures, that progressively destroys the bone and can lead to bone necrosis, even with a decrease in mortality, since it is difficult to eradicate, with high rates of treatment failure. There is a lack of studies on the condition in Brazil, especially in the Northeast, and it is relevant to analyze its profile and isolate risk factors to define better protocols for its management. Objective To identify clinical and epidemiological characteristics and factors that impact the unfavorable outcome of the treatment of patients with post-traumatic osteomyelitis at the Hospital Universitário de Lagarto (HUL). Methodology An observational historical cohort study was developed evaluating 24 patients with osteomyelitis after fractures at HUL between September 2022 and September 2023, using secondary data collected from medical records. Results The predominance of the disease in men, closed surgical fractures and tibial fractures was evaluated, presenting mainly with secretion in an active fistula. The most common etiological agent is S. aureus, with the most frequent empirical treatment being the combination of Ciprofloxacin and Clindamycin for approximately 15 to 30 days. Polymicrobial infections caused by resistant strains of S. aureus (MRSA) and multiple surgical approaches were identified as risk factors for worse outcomes (RR > 1, p < 0.05). Conclusions For a more effective therapeutic approach to osteomyelitis, adequate antibiotic therapy should be combined, paying attention to broader coverage, including MRSA and polymicrobial infections, as well as adequate early surgical management.