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. Résumé,

L. Triméthoprime-sulfaméthoxazole, Les données dans la littérature concernant son efficacité et sa tolérance dans les infections non staphylococciques sont encore limitées. L'objectif de notre étude était de comparer efficacité et tolérance de différentes associations

, Les dossiers des patients avec prescription de TMP-SMX entre 2013 et 2018 pour une IOA ont été analysés. L'échec du traitement était défini comme la persistance/réapparition de signes d'infection, nécessité d'une thérapie de sauvetage ou d'une réintervention chirurgicale. Nous avons étudié l'efficacité

, Les atteintes cutanées et digestives étaient les plus fréquentes respectivement 8,4% et 19% des patients. La survenue d'une intolérance était plus élevée avec les quinolones (17/56) et la rifampicine (17/40) en association mais ne semblait pas diminuer le taux de succès, prescriptions de TMP-SMX pour IOA ont été initiées, 33 (25%) ont dû être interrompu en raison d'une intolérance après une durée médiane de 14 jours, pp.37-84

, Dans les infections à Staphylococcus aureus il était de 65% et 66,7% pour les SARM. Parmi les 33 infections associées au matériel d'ostéosynthèse, 20 étaient à bacilles gram négatif (BGN) ou polymicrobiennes avec un taux de succès de 75%. Quand l'utilisation du TMP-SMX était nécessaire en raison d'alternatives limités (n=49), le taux de succès était de 81, p.63

, Une incidence élevée d'interruption de traitement pour intolérance suggère un suivi rapproché des associations contenant du TMP-SMX, en particulier associé aux quinolones et à la rifampicine. Le taux de succès semble élevé notamment dans les infections à BGN et polymicrobiennes sur matériel d

, Mots clés : Triméthoprime-sulfaméthoxazole, Infections ostéo-articulaires, tolérance, rifampicine, quinolone, bacille gram négatifs