Elution of High Dose Amphotericin B Deoxycholate From Polymethylmethacrylate

Houdek, Matthew T.; Greenwood‐Quaintance, Kerryl E.; Morrey, Mark E.; Patel, Robin; Hanssen, Arlen D.

doi:10.1016/j.arth.2015.06.002

Cited by 12 publications

(10 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study found active amphotericin B release (0.02%) from PMMA beads to be the best agent for local elution and duration. Similarly, Houdek et al 38 found high-dose amphotericin B PMMA beads to be efficacious with regard to active antibiotic bioavailability and at levels over the reported minimal inhibitory concentration of Candida albicans without the addition of a poragen or the use of a liposomal form. Antifungal beads can help augment local antimicrobial elution and concentration in situations where cement spacers may already include other antibiotics.…”

Section: Antifungal Beadsmentioning

confidence: 93%

“…One study from the Mayo Clinic reported success of amphotericin B in cement at markedly higher doses (3 g/40 g PMMA) than published in previous literature. 38 Martínez-Moreno et al 39 recently explored the efficacy and bioactivity of ceftazidime and fluconazole in PMMA bone cement at prophylaxis and treatment levels. The authors concluded that the bioactivity of the two antimicrobials in a proportion of 1 g/40 g cement depended on the sensitivity of the microorganism within 72-hours after surgery.…”

Section: Antifungal Spacersmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and Management of Fungal Periprosthetic Joint Infections

Nace

Talmo

Chen

2019

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Fungal periprosthetic joint infection (PJI) is a devastating complication because it can be difficult to diagnose, manage, and eradicate. Fungal PJI treatment requires a systematic approach. Increased awareness is essential when patients with painful arthroplasties present with immunosuppression, significant comorbidities, multiple surgeries, and history of drug use. Every suspected fungal PJI should be promptly diagnosed using readily available serum and synovial fluid markers. Surgical management involves débridement, antibiotics, and implant retention, onestage exchange arthroplasty, prosthetic articulating spacers, and two-stage exchange arthroplasty. Because mycotic infections develop robust biofilms, the utility of débridement, antibiotics, and implant retention and one-stage revisions seem limited. A thorough irrigation and débridement is essential to decrease infection burden. Adjunctive local and systemic antifungal therapy is critical, although the agent choice and duration should be tailored appropriately. Future high-quality studies are needed to develop standardized guidelines for the management of fungal PJI.M ore than 1 million total joint arthroplasties (TJAs) are performed in the United States annually, 1 with notable increases projected over the next few decades. 2 With the increasing number of TJAs, periprosthetic joint infections (PJIs) are projected to increase over time. Although notable improvements have reduced the rate of PJI, 3 infection still remains a common cause of revision TJA. 4 Although gram-positive organisms are responsible for most PJIs, 5 fungal infections are increasing in prevalence. 6 Fungal PJI represents 1% of all joint infections, and its diagnosis may be more difficult compared with bacterial pathogens because of diverse clinical presentations. Sur-gical and medical management of fungal PJI are more challenging than gram-positive or negative infections because patients are often immunocompromised with a higher risk of persistent infection. Although increased attention has been dedicated to the diagnosis and management of bacterial septic joints, no standardized guidelines exist for the diagnosis and management of fungal PJI because of its rarity. It is unknown if the protocol for treating bacterial PJI can also be extrapolated to fungi, as there is inconsistent data with regards to the use of systemic, local and oral antifungal agents. This review carefully outlines the diagnosis and management options for fungal PJI.

show abstract

Section: Antifungal Beadsmentioning

confidence: 93%

Section: Antifungal Spacersmentioning

confidence: 99%

Diagnosis and Management of Fungal Periprosthetic Joint Infections

Nace

Talmo

Chen

2019

J Am Acad Orthop Surg

View full text Add to dashboard Cite

show abstract

“…Antifungals, including amphotericin and voriconazole, are also stable in PMMA and can be added in the setting of fungal infection. 33 34 35…”

Section: Treatment Of Infected Tkamentioning

confidence: 99%

“…Antifungals, including amphotericin and voriconazole, are also stable in PMMA and can be added in the setting of fungal infection. [33][34][35] There is also a choice between static versus articulating spacers. This decision is typically made by the surgeons, based on the status of the surrounding soft tissues and the quality of the remaining bone.…”

Section: Two-stage Revisionmentioning

confidence: 99%

Current Insights in the Evaluation and Treatment of Infected Total Knee Arthroplasty

Ashley

Parvızı

2021

J Knee Surg

View full text Add to dashboard Cite

Total knee arthroplasty is a widely successful procedure, but a small percentage of patients have a postoperative course complicated by periprosthetic joint infection (PJI). PJI is a difficult problem to diagnose and to treat, and the management of PJI differs, depending on the acuity of the infection. This paper discusses the established and newer technologies developed for the diagnosis of PJI as well as different treatment considerations and surgical solutions currently available.

show abstract

“…O mecanismo responsável pela efetividade do uso de antimicrobianos no cimento ortopédico é a eluição. A anfotericina B foi o antifúngico mais utilizado nos casos descritos nesta revisão e publicações recentes corroboram a liberação de anfotericina B do cimento ortopédico (80,81) em oposição ao que mostrou Goss et. al.…”

Section: Discussão Dos Resultados Da Revisão Da Literaturaunclassified

Infecção por espécies de Candida em próteses articulares: revisão da literatura e caracterização clínica dos casos conduzidos no Instituto de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo

Saconi¹

View full text Add to dashboard Cite

Elution of High Dose Amphotericin B Deoxycholate From Polymethylmethacrylate

Cited by 12 publications

References 14 publications

Diagnosis and Management of Fungal Periprosthetic Joint Infections

Diagnosis and Management of Fungal Periprosthetic Joint Infections

Current Insights in the Evaluation and Treatment of Infected Total Knee Arthroplasty

Infecção por espécies de Candida em próteses articulares: revisão da literatura e caracterização clínica dos casos conduzidos no Instituto de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo

Contact Info

Product

Resources

About