Vancomycin and Ceftazidime in Bone Cement as a Potentially Effective Treatment for Knee Periprosthetic Joint Infection

Hsu, Yung‐Heng; Hu, Chih-Chien; Hsieh, Pang‐Hsin; Shih, Hsin-Nung; Ueng, Steve Wen–Neng; Chang, Yu‐Han

doi:10.2106/jbjs.16.00290

Cited by 62 publications

(61 citation statements)

References 24 publications

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“…An antibiotic to be mixed with the cement must be thermally stable with the exothermic reaction of polymerization, must not compromise the mechanical integrity of the cement and must elute from the cement for a certain period of time [7]. There are few studies regarding the mechanical properties of these cements mixed in the operating theatre [8,9], the majority of studies are targeted on the dose and time of local released antibiotic [10][11][12][13].…”

mentioning

confidence: 99%

Mechanical Behaviour of Orthopaedic Cement Loaded with Antibiotics in the Operation Room

Fleacă¹,

Mitariu²,

Oleksik³

et al. 2017

Mat.Plast.

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Using antibiotic impregnated cement is an important mean to treat and prevent periprostetic joint infections. This complication requires for treatment important financial and technical resources. Adding antibiotics to orthopaedic cement may alter its mechanical properties with possible reduced time of prosthesis survival rate. This study analyze the mechanical properties of cement mixed with antibiotics in the operation room, which helps reducing costs and permit a more specific antibiotic local therapy. All tested antibiotics used in this study does not change the mechanical behavior of the orthopaedic cement when mixed in therapeutic doses, all alterations seems to be at a level below clinical significance. Mixing antibiotics in Orthopedic cement leads to minor decrease of the mechanical properties for cefazolin, cefuroxime, ceftazidime, meropenem and vancomycin and a mechanical significant decrease for gentamicin and clindamycin.

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mentioning

confidence: 99%

Mechanical Behaviour of Orthopaedic Cement Loaded with Antibiotics in the Operation Room

Fleacă¹,

Mitariu²,

Oleksik³

et al. 2017

Mat.Plast.

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“…Application of multiple antibiotics broadens the antimicrobial spectrum but leads to defects in mechanical performance, and thus, this type of ALBC is usually used as beads or spacers. Hsu et al [ 66 ] produced bone cement specimens loaded with 4 g of either vancomycin or teicoplanin and 4 g of ceftazidime, imipenem or aztreonam and then measured the in vitro elution characteristics and antibacterial capacities of the specimens. The most effective combination was implanted into eight chronic PJI patients to assess in vivo drug dose and bioactivity.…”

Section: Clinical Applications Of Albcmentioning

confidence: 99%

“…Vancomycin and ceftazidime, the elected best choice, exhibited good capacities in both the laboratory and clinical practice. [ 66 ] In another prospective study investigating gentamycin-clindamycin loaded cement, 32 subjects were divided into two groups: PJI patients underwent a one-stage exchange, and aseptic loosening patients underwent revision or primary arthroplasty but were considered at high risk for infection. At the end of a 5-year follow-up, no reinfection was found.…”

Section: Clinical Applications Of Albcmentioning

confidence: 99%

Progress of antibiotic-loaded bone cement in joint arthroplasty

Peng

Feng

et al. 2020

Chinese Medical Journal

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Bone cement, consisting of polymethyl methacrylate, is a bioinert material used for prothesis fixation in joint arthroplasty. To treat orthopedic infections, such as periprosthetic joint infection, antibiotic-loaded bone cement (ALBC) was introduced into clinical practice. Recent studies have revealed the limitations of the antibacterial effect of ALBC. Moreover, with the increase in high infection risk patients and highly resistant microbes, more researches and modification of ALBC are required. This paper reviewed latest findings about ALBC for most popular and destructive pathogens, summarized the influence of antibiotic kind, drug dosage, application method, and environment towards characteristic of ALBC. Subsequently, new cement additives and clinical applications of ALBC in joint arthroplasty were also discussed.

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“…In response to the above limitations, investigators have responded by changing the mixing process of PMMA to increase porosity and improve elution profiles [44], using binding agents to increase elution [46] and using newer antibiotics with longer half-lives in an effort to prolong their intraarticular effects [47]. More recently, good PJI treatment success rates have been reported by introducing a percutaneous catheter at the time of revision surgery and regularly infusing antibiotics into the joint space for several weeks [48].…”

Section: Contemporary Treatment Of Pji: Limited Successmentioning

confidence: 99%

Current Options and Emerging Biomaterials for Periprosthetic Joint Infection

et al. 2018

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Recent advancements in local antibiotic delivery platforms for preventing and treating PJI include titanium nanotube arrays, synthetic polymers, resorbable hydrogels, and cyclodextrin-based drug delivery options. In particular, cyclodextrins have facilitated great advancements in other clinical disorders and have demonstrated early promise as a future option in the arena of PJI. Novel treatment modalities for PJI optimize the implant surfaces to prevent bacterial biofilm formation or provide prolonged intra-articular antibiotic dosing to eradicate bacteria.

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Vancomycin and Ceftazidime in Bone Cement as a Potentially Effective Treatment for Knee Periprosthetic Joint Infection

Abstract: This study confirmed the potential effectiveness of drug delivery from bone cement spacers impregnated with vancomycin and ceftazidime.

Cited by 62 publications

References 24 publications

Mechanical Behaviour of Orthopaedic Cement Loaded with Antibiotics in the Operation Room

Mechanical Behaviour of Orthopaedic Cement Loaded with Antibiotics in the Operation Room

Progress of antibiotic-loaded bone cement in joint arthroplasty

Current Options and Emerging Biomaterials for Periprosthetic Joint Infection

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