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含抗生素的可溶解合成钙在糖尿病患者骨关节炎感染中的应用

The Use of Dissolvable Synthetic Calcium Impregnated with Antibiotic in Osteoarticular Infection in Patients with Diabetes.

作者信息

Cursaru Adrian, Cursaru Raluca, Iordache Sergiu, Costache Mihai Aurel, Cretu Bogdan Stefan, Serban Bogdan, Popa Mihnea-Ioan-Gabriel, Cirstoiu Catalin

机构信息

Orthopedics and Traumatology Department, University Emergency Hospital, 050098 Bucharest, Romania.

Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, 014464 Bucharest, Romania.

出版信息

Life (Basel). 2024 Oct 20;14(10):1335. doi: 10.3390/life14101335.

Abstract

The medical management of osteoarticular infections in patients with diabetes continues to be a considerable clinical dilemma because of inadequate blood supply and weakened immune systems. The objective of this study is to assess the effectiveness of dissolvable synthetic pure calcium sulfate beads with antibiotics in the treatment of osteoarticular infections in individuals diagnosed with diabetes mellitus. A retrospective analysis was conducted on 27 patients with diabetes (19 with type II diabetes and 8 with type I diabetes) who were diagnosed with osteoarticular infections and received treatment with locally delivered antibiotic-loaded calcium sulfate beads. The patients were monitored for a duration ranging from 6 months to 2 years, during which the clearance of infection, bone remodeling, and rates of recurrence were evaluated. The evaluation also included an assessment of glycemic control and its influence on infection treatment. The findings revealed a notable decrease in the recurrence of infections, as patients who were given combinations of two antibiotics showed better results in comparison to those who were exclusively treated with one antibiotic. A 92% eradication rate was achieved within the trial group, and patients who had dual-antibiotic treatment did not have any return of illness. Postoperative bone remodeling was shown to take place between 8 and 16 weeks, with faster recovery in individuals who maintained ideal glycemic control (HbA1c < 7%). Only one instance of soft tissue necrosis was documented, indicating minimal consequences. The results validate the use of dissolvable synthetic calcium sulfate as a secure and efficient local antibiotic administration method for controlling osteoarticular infections in patients with diabetes, providing improved infection management and facilitating bone regeneration.

摘要

由于血液供应不足和免疫系统减弱,糖尿病患者骨关节炎感染的药物治疗仍然是一个相当大的临床难题。本研究的目的是评估含抗生素的可溶解合成纯硫酸钙珠在治疗糖尿病患者骨关节炎感染中的有效性。对27例诊断为骨关节炎感染并接受局部递送含抗生素硫酸钙珠治疗的糖尿病患者(19例II型糖尿病患者和8例I型糖尿病患者)进行了回顾性分析。对患者进行了6个月至2年的监测,在此期间评估感染清除情况、骨重塑情况和复发率。评估还包括对血糖控制及其对感染治疗影响的评估。研究结果显示感染复发率显著降低,因为接受两种抗生素联合治疗的患者与仅接受一种抗生素治疗的患者相比,效果更好。试验组实现了92%的根除率,接受双联抗生素治疗的患者没有任何疾病复发。术后骨重塑发生在8至16周之间,血糖控制理想(糖化血红蛋白<7%)的个体恢复更快。仅记录到1例软组织坏死病例,表明后果轻微。结果证实可溶解合成硫酸钙作为一种安全有效的局部抗生素给药方法,可用于控制糖尿病患者的骨关节炎感染,改善感染管理并促进骨再生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6353/11509661/a7eba89d40ef/life-14-01335-g008.jpg

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