Ferreira Luís, Pos Ema, Nogueira Daniela Rodrigues, Ferreira Filipa Pinto, Sousa Ricardo, Abreu Miguel Araújo
Department of Infectious Diseases, Centro Hospitalar e Universitário de Santo António, Porto, Portugal.
Department of Orthopaedic Surgery, Centro Hospitalar e Universitário de Santo António, Porto, Portugal.
Front Microbiol. 2024 Aug 29;15:1435720. doi: 10.3389/fmicb.2024.1435720. eCollection 2024.
The management of prosthetic joint infections is a complex and multilayered process that is additionally complicated by the formation of bacterial biofilm. Foreign material provides the ideal grounds for the development of an intricate matrix that hinders treatment and creates a difficult environment for antibiotics to act. Surgical intervention is often warranted but requires appropriate adjunctive therapy. Despite available guidelines, several aspects of antibiotic therapy with antibiofilm activity lack clear definition. Given the escalating challenges posed by antimicrobial resistance, extended treatment durations, and tolerance issues, it is essential to ensure that antimicrobials with antibiofilm activity are both potent and diverse. Evidence of biofilm-active drugs is highlighted, and alternatives to classical regimens are further discussed.
人工关节感染的管理是一个复杂且多层次的过程，细菌生物膜的形成使其更加复杂。异物为复杂基质的形成提供了理想场所，这种基质会阻碍治疗，并为抗生素发挥作用创造困难环境。通常需要进行手术干预，但需要适当的辅助治疗。尽管有可用的指南，但具有抗生物膜活性的抗生素治疗的几个方面仍缺乏明确的定义。鉴于抗菌药物耐药性、延长治疗时间和耐受性问题带来的挑战不断升级，确保具有抗生物膜活性的抗菌药物既有效又多样至关重要。强调了具有生物膜活性药物的证据，并进一步讨论了经典治疗方案的替代方案。
