High active local levels of vancomycin without nephrotoxicity released from impacted bone allografts in 20 revision hip arthroplasties

Abstract

Local levels of vancomycin were 35 times greater than the highest levels reported with vancomycin-loaded PMMA. A synergistic effect was observed between vancomycin released from impacted allografts and aminoglycoside-loaded PMMA.

The effect of Vancomycin degradation products in the topical treatment of osteomyelitis

“…For the in vitro experiment, morselized cancellous bone grafts were chosen as local antibiotic carriers due to their appropriate properties and availability (1,3,5,8,9,10). For antibiotic impregnation of bone grafts, Vancomycin powder (Vancomycin Mylan ®) was used.…”

“…One of the ways to increase therapeutic potential is to use local antibiotic delivery system (3,8,10,13,14,15). The topical antibiotic treatment of musculoskeletal infections has the advantage over systemic antibiotics of achieving high antibiotic concentrations, exceeding the minimum inhibitory concentration (MIC) without increasing systemic toxicity.…”

Allogene spongiöse Knochenpräparate als Antibiotikaträger

“…Aus Coraca-Huber et al [18] endoprothetik gut belegt [13][14][15]. Ergebnisse mit verdichteten Knochenchips, dem "impaction bone grafting", haben gezeigt, dass durch die Zugabe von Antibiotika zu den Knochenchips eine hohe lokale Antibiotikakonzentration erzielt wird, die mit rein systemischer Antibiose nichterreichtwerdenkann [13,16,17] …”

Antibiotic Impregnated Bone Grafts — What Do We Know?

“…2). The local antibiotic concentration is above MIC of vancomycin against most strains of S. aureus and S. epidermidis for at least 48 hours [8]. The antibiotic concentration in the wound drainage fluid in patients receiving cancellous bone impregnated with aminoglycoside is considerably higher than that recorded when using gentamicin-containing bone cement [3,4,20,30,32,33,39].…”

“…During the last decade several in vitro and in vivo studies have been published on cancellous and cortical bone as antibiotic carriers, and also clinical studies [5,6,7,8,27,35,36,37,38,39,40].…”