Davenport K, Traina S, Perry C
Marquette General Hospital, Michigan.
J Arthroplasty. 1991 Jun;6(2):179-83. doi: 10.1016/s0883-5403(11)80014-8.
The authors have identified 22 patients with acutely infected total joint arthroplasties, 9 hips, and 13 knees. Following organism identification and assessment of the patients' general medical condition, the patients were treated with an implantable antibiotic pump. This allowed the delivery of a high concentration of antibiotic solution to a localized area. Systemic levels of antibiotic were kept to a minimum, thereby eliminating potential serious side effects of antibiotic treatment. Local concentrations were extremely high, exceeding the minimal inhibitory concentration (MIC) in all cases by 8-10-fold. Twenty patients have been followed for 30 months, and of these, 17 patients are considered to be infection free. There were three failures. The organisms that have been treated have been gram negatives, gram positives, and some mixed infections. Results are encouraging with this form of treatment, and additional patients are continually being added to the study.
作者们确定了22例全关节置换术后急性感染患者，其中9例为髋关节感染，13例为膝关节感染。在确定病原体并评估患者的总体健康状况后，对这些患者采用了植入式抗生素泵进行治疗。这使得高浓度的抗生素溶液能够输送到局部区域。抗生素的全身水平保持在最低限度，从而消除了抗生素治疗潜在的严重副作用。局部浓度极高，在所有病例中均超过最低抑菌浓度（MIC）8至10倍。20例患者已随访30个月，其中17例被认为无感染。有3例治疗失败。接受治疗的病原体包括革兰氏阴性菌、革兰氏阳性菌以及一些混合感染。这种治疗方式的结果令人鼓舞，该研究也在持续纳入更多患者。
