Bálint Lehel, Koós Zoltán, Liszt Ferenc, Kocsis Béla, Farkas Boglárka, Szabó György
Pécsi Tudományegyetem, Orvos- és Egészségtudományi Centrum, Altalános Orvostudományi Kar, Ortopédiai Klinika, Pécs.
Orv Hetil. 2004 Jul 11;145(28):1467-71.
The authors report their in vivo and in vitro results of the elution characteristics of gentamycin sulfate from bone cement, which is the most commonly used way of local antibiotic prophylaxis in Europe in the field of orthopedic surgery.
The aim of this study was to investigate the elution of the gentamycin sulfate from bone cement, describe the dynamics of the emission in time and evaluate the relationship between the minimal inhibitory concentration (MIC) and the eluted concentration of the antibiotic.
The in vivo investigation samples were taken from 9 patient from drain fluids to evaluate the eluted antibiotic concentration by fluorescent polarisation immunoassay method (FPI). The in vitro emission-dynamics of two different bone cement-Gentamycin sulphate complex were analysed by plate diffusion method during one-year period after mixing.
Their results showed that 24 hours after the operation the gentamycin concentrations in the drain fluid taken from around the endoprosthesis implanted with Palacos-R bone cement diminished, yet remained above the MIC level. High but rapidly decreasing antibiotic level was detected by the in vitro method within the first week, reading an almost steadily low concentration by the end of the first month. Surprisingly, after one year it was still possible to demonstrate the inhibitory effect of the drug from both tested types of cements.
It is concluded that the gentamycin is able to elute from the bone cement in useful concentration after the implantation of endoprosthesis. However, this in vitro method is a useful and reproducible technique for the measurement of the efficacy of antibiotic emission from bone cement, the conversation of the results to the in vivo remains to be obscured. Nevertheless, the usage of local antibiotic prophylaxis seems to be useful during orthopaedic major intervention.
作者报告了硫酸庆大霉素从骨水泥中洗脱特性的体内和体外研究结果,这是欧洲骨科手术领域中最常用的局部抗生素预防方法。
本研究旨在调查硫酸庆大霉素从骨水泥中的洗脱情况,描述其随时间的释放动态,并评估最低抑菌浓度(MIC)与抗生素洗脱浓度之间的关系。
体内研究样本取自9名患者的引流液,通过荧光偏振免疫分析法(FPI)评估洗脱的抗生素浓度。采用平板扩散法分析两种不同骨水泥 - 硫酸庆大霉素复合物在混合后一年内的体外释放动态。
他们的结果表明,在植入Palacos - R骨水泥的假体周围采集的引流液中,术后24小时庆大霉素浓度下降,但仍高于MIC水平。体外方法在第一周内检测到抗生素水平较高但迅速下降,到第一个月末读数几乎稳定在低浓度。令人惊讶的是,一年后仍能证明两种测试类型骨水泥中的药物具有抑制作用。
得出结论认为,在植入假体后,庆大霉素能够以有效浓度从骨水泥中洗脱。然而,这种体外方法是一种用于测量骨水泥抗生素释放效果的有用且可重复的技术,但其结果与体内情况的相关性仍不明确。尽管如此,但在骨科大手术中使用局部抗生素预防似乎是有用的。