Bioavailability of Gentamicin and Vancomycin Released from an Antibiotic Containing Bone Cement in Patients Undergoing a Septic One-Stage Total Hip Arthroplasty (THA) Revision: A Monocentric Open Clinical Trial

Kendoff, Daniel; Gehrke, Thorsten; Stangenberg, P.; Frommelt, Lars; Bösebeck, Hans

doi:10.5301/hipint.5000307

Cited by 29 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean postoperative maximum gentamicin plasma concentration at 5.85 h was 209.65 ng/mL. For vancomycin, a mean postoperative maximum plasma concentration of 134.64 ng/mL was determined at 20.03 h. The authors concluded that there was slow absorption of both antibiotics after release from the cement, resulting in plasma concentrations well below toxic levels, which would not result in a critical systemic concentration potentially inducing bacterial resistance. In any case, ALBC are safe from the pharmacotherapeutical point of view, with a very low systemic absorption.…”

Section: Release Kineticsmentioning

confidence: 97%

Antibiotic‐loaded Bone Cement as Prophylaxis in Total Joint Replacement

Martínez-Moreno

Merino

Nácher

et al. 2017

Orthopaedic Surgery

View full text Add to dashboard Cite

One of its most serious complications associated with arthroplasty is the development of infections. Although its prevalence is only between 0.5% and 3%, in some cases it can lead to death. Therefore, an important challenge in joint surgery is the prevention of infections when an arthroplasty is performed. The use of antibiotic-loaded cements could be a suitable tool due to numerous advantages. The main advantage of the use of antibiotic loading into bone cement derives directly from antibiotic release in the effect site, allowing achievement of high concentrations at the site of action, and minimal or no systemic toxicity. This route of administration was first described by Buchholz and Engelbrecht. In the case of infection treatment, this is an established method and its good results have been confirmed. However, its role in infection prevention, and, therefore, the use of these systems in clinical practice, has proved controversial because of the uncertainty about the development of possible antibiotic resistance after prolonged exposure time, their effectiveness, the cost of the systems, toxicity and loosening of mechanical properties. This review discusses all these topics, focusing on effectiveness and safety, antibiotic decisions, cement type, mixing method, release kinetics and future perspectives. The final objective is to provide the orthopaedic surgeons the right information in their clinical practice based on current evidence.

show abstract

Section: Release Kineticsmentioning

confidence: 97%

Antibiotic‐loaded Bone Cement as Prophylaxis in Total Joint Replacement

Martínez-Moreno

Merino

Nácher

et al. 2017

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…Local delivery of antibiotics like gentamicin or vancomycin has been long applied in bone cements that are used to fix prosthetic implants . However, a number of recent studies support the lack of efficacy of these antibiotic‐loaded bone cements (AL‐BC) .…”

Section: Antimicrobial Coatingsmentioning

confidence: 99%

Antifouling and antimicrobial biomaterials: an overview

Francolini

Vuotto

Piozzi

et al. 2017

APMIS

263

220

View full text Add to dashboard Cite

The use of implantable medical devices is a common and indispensable part of medical care for both diagnostic and therapeutic purposes. However, as side effect, the implant of medical devices quite often leads to the occurrence of difficult‐to‐treat infections, as a consequence of the colonization of their abiotic surfaces by biofilm‐growing microorganisms increasingly resistant to antimicrobial therapies. A promising strategy to combat device‐related infections is based on anti‐infective biomaterials that either repel microbes, so they cannot attach to the device surfaces, or kill them in the surrounding areas. In general, such biomaterials are characterized by antifouling coatings, exhibiting low adhesion or even repellent properties towards microorganisms, or antimicrobial coatings, able to kill microbes approaching the surface. In this light, the present overview will address the development in the last two decades of antifouling and antimicrobial biomaterials designed to potentially limit the initial stages of microbial adhesion, as well as the microbial growth and biofilm formation on medical device surfaces.

show abstract

“…In cemented THAs we have been using the Optipac Refobacin Bone Cement R system (Zimmer-Biomet, Dieticon, Switzerland) with the 40 g package for cup fixation and 60 g mixed for stem fixation. In the 40 g of the cement polymer is 0.5 g of active gentamicin, which has an established bactericidal effect on particularly gram-positive organisms like Staphylococcus aureus and CoNS (Kendoff et al, 2016;Khassebaf et al, 2015). Cutibacterium acnes growing in biofilm has proven susceptibility to locally administered gentamicin (Ramage et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Periprosthetic hip infections in a Swedish regional hospital between 2012 and 2018: is there a relationship between <i>Cutibacterium acnes</i> infections and uncemented prostheses?

Hedlundh

Zacharatos

Magnússon

et al. 2021

J. Bone Joint Infect.

View full text Add to dashboard Cite

Abstract. The purpose of this study was to evaluate patients requiring in-patient care due to a periprosthetic joint infection (PJI), with respect to bacterial agents, surgical treatment, antibiotics, and outcome. We retrospectively identified all infected total hip arthroplasties (THAs) in a Swedish regional hospital during a 7-year period (2012–2018) and reviewed medical records and microbiological data. A total of 89 infected THAs in 87 patients were identified. Standardized treatment with debridement with retention of the implant and antibiotics (DAIR) was initially performed in 53 cases (60 %), one or two stage revisions in 33 cases (37 %), and an immediate Girdlestone in 3 cases (3 %). Infection eradication was seen in 77 PJIs (87 %) in addition to six patients (7 %) ending up with a permanent but uninfected Girdlestone. All six patients with manifest failures were infected with Staphylococcus aureus, two of which were also polymicrobial. Cutibacterium acnes was found in 18 of 89 patients (16 %) distributed in 15 uncemented implants but only in 3 hybrids and cemented arthroplasties, while remaining pathogens were equally distributed in uncemented THAs (n=31) and THAs with at least one cemented component (n=40; p=0.003). Eradication was achieved in all 18 patients when Cutibacterium acnes was the only culture (n=14) or clearly dominant among positive cultures (n=4). DAIR was successful in selected postoperative infections up to 6 months after hip replacement. Cutibacterium acnes infections in hip arthroplasty may be underdiagnosed. Cemented components in THAs seem to protect from colonization with Cutibacterium acnes.

show abstract

Bioavailability of Gentamicin and Vancomycin Released from an Antibiotic Containing Bone Cement in Patients Undergoing a Septic One-Stage Total Hip Arthroplasty (THA) Revision: A Monocentric Open Clinical Trial

Cited by 29 publications

References 25 publications

Antibiotic‐loaded Bone Cement as Prophylaxis in Total Joint Replacement

Antibiotic‐loaded Bone Cement as Prophylaxis in Total Joint Replacement

Antifouling and antimicrobial biomaterials: an overview

Periprosthetic hip infections in a Swedish regional hospital between 2012 and 2018: is there a relationship between <i>Cutibacterium acnes</i> infections and uncemented prostheses?

Contact Info

Product

Resources

About

Bioavailability of Gentamicin and Vancomycin Released from an Antibiotic Containing Bone Cement in Patients Undergoing a Septic One-Stage Total Hip Arthroplasty (THA) Revision: A Monocentric Open Clinical Trial

Cited by 29 publications

References 25 publications

Antibiotic‐loaded Bone Cement as Prophylaxis in Total Joint Replacement

Antibiotic‐loaded Bone Cement as Prophylaxis in Total Joint Replacement

Antifouling and antimicrobial biomaterials: an overview

Periprosthetic hip infections in a Swedish regional hospital between 2012 and 2018: is there a relationship between &lt;i&gt;Cutibacterium acnes&lt;/i&gt; infections and uncemented prostheses?

Contact Info

Product

Resources

About

Periprosthetic hip infections in a Swedish regional hospital between 2012 and 2018: is there a relationship between <i>Cutibacterium acnes</i> infections and uncemented prostheses?