Vancomycin-Impregnated Bone Cement Beads

Autor:	Fuminori Kanaya, Satoshi Kinjo, Kunio Ibaraki, Jun Asato, Hideyuki Sunagawa
Rok vydání:	1996
Předmět:	business.industry biochemical phenomena metabolism and nutrition MRSA infection Serum concentration medicine.disease_cause Bone cement Microbiology Minimum inhibitory concentration Chronic osteomyelitis Staphylococcus aureus medicine Vancomycin Peak value business medicine.drug
Zdroj:	Orthopedics & Traumatology. 45:774-777
ISSN:	1349-4333 0037-1033
DOI:	10.5035/nishiseisai.45.774
Popis:	Antibiotic-impregnated bone cement beads have been popularized for the treatment of chronic osteomyelitis. Many surgeons have used aminoglycoside-impregnated beads, because aminoglycosides are heat-stable during polymerization of PMMA and have a broad antibacterial spectrum. Unfortunately, aminoglycosides are not very effective against methicillin-resistant staphylococcus aureus (MRSA) infections. Cement beads have not been impregnated with vancomycin because of its heat-liability. With vancomycin-impregnated beads (VCM-beads), we were successful in treating a 58 year-old man, who had an MRSA infection after THR. The local concentration of vancomycin was 85.23μg/ml at 24 hours after surgery, 9.34μg/ml at 7 days, 3.69μg/ml at 14 days. These values were well above the minimum inhibitory concentration (MIC, 1.56μg/ml). The serum concentration of vancomycin reached the peak (2.96μg/ml) 4 hours after surgery. This peak value was under the safety limit, and the serum concentration of vancomycin was undetectable after 4 days. From this study, VCM-beads were proved to be effective for deep MRSA infection and local concentration of vancomycin beads was well above the MIC at least 2 weeks after insertion.
Databáze:	OpenAIRE
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