Shirtliff Mark E, Calhoun Jason H, Mader Jon T
Center for Biofilm Engineering, Montana State University, Bozeman, MT 59717-3980, USA.
Clin Orthop Relat Res. 2002 Aug(401):239-47. doi: 10.1097/00003086-200208000-00027.
A calcium hydroxyapatite antibiotic implant was evaluated to determine its efficacy as an antibiotic delivery system in a localized osteomyelitis rabbit model. Localized rabbit tibial osteomyelitis was developed with an intramedullary injection of methicillin resistant Staphylococcus aureus. Infected rabbits were randomized and divided into eight groups depending on treatment with or without debridement, systemic antibiotics, antibiotic-impregnated polymethylmethacrylate beads, or calcium hydroxyapatite implants with and without antibiotic impregnation. All treatments began 2 weeks after infection. After 4 weeks of therapy, the involved bones were cultured for concentrations of Staphylococcus aureus per gram of bone. Rabbits (n = 11) that had calcium hydroxyapatite (impregnated with vancomycin) implanted into the dead space after the debridement surgery had an 81.8% infection clearance after treatment. Rabbits (n = 10) that had polymethylmethacrylate beads (impregnated with vancomycin) implanted into the dead space after debridement surgery had a 70% clearance rate. All other treatment modalities resulted in less than 50% clearance rates. Calcium hydroxyapatite may be an effective alternative to polymethylmethacrylate for providing local antibiotic therapy in cases of methicillin resistant Staphylococcus aureus osteomyelitis.
对一种羟基磷灰石钙抗生素植入物进行了评估,以确定其在局部骨髓炎兔模型中作为抗生素递送系统的疗效。通过髓内注射耐甲氧西林金黄色葡萄球菌建立局部兔胫骨骨髓炎模型。感染的兔子根据是否进行清创、全身使用抗生素、抗生素浸渍的聚甲基丙烯酸甲酯珠或有无抗生素浸渍的羟基磷灰石植入物进行治疗,随机分为八组。所有治疗在感染后2周开始。治疗4周后,对受累骨骼进行培养,测定每克骨中金黄色葡萄球菌的浓度。在清创手术后将羟基磷灰石(浸渍万古霉素)植入死腔的兔子(n = 11),治疗后感染清除率为81.8%。在清创手术后将聚甲基丙烯酸甲酯珠(浸渍万古霉素)植入死腔的兔子(n = 10),清除率为70%。所有其他治疗方式的清除率均低于50%。在耐甲氧西林金黄色葡萄球菌骨髓炎病例中,羟基磷灰石可能是聚甲基丙烯酸甲酯用于提供局部抗生素治疗的有效替代品。