Perry C R, Rice S, Ritterbusch J K, Burdge R E
Clin Orthop Relat Res. 1985 Jan-Feb(192):284-90.
A totally implantable drug pump was evaluated as a delivery system in the treatment of osteomyelitis. Gentamicin levels in rabbit serum and bone obtained by systemic administration are compared with levels in rabbit serum and bone obtained by local administration via an implantable drug pump. Systemic administration gave mean gentamicin bone levels ranging from less than 1 microgram/gm to 3.6 micrograms/gm, while drug pump administration gave bone levels ranging from 10.8 micrograms/gm to 64.0 micrograms/gm (micrograms = microgram, or 10(-6) gram). To evaluate the drug pump as a mode of therapy, acute staphylococcal osteomyelitis was induced in ten rabbits. Drug pumps filled with amikacin were inserted in five of the infected animals. Three of these were culture-negative at one week. One had a scant growth of Staphylococcus from the pump, and one had scant growth from the pump and the wound. Clinically, none of these five rabbits appeared infected at seven days. The remaining five rabbits were all culture-positive, with heavy growths of staphylococci from their wounds, and clinically, all appeared grossly infected at seven days. These data demonstrate that high local and low systemic levels of antibiotics can be achieved with an implantable drug pump and that this method can sterilize an infected musculoskeletal wound. Therefore, antibiotic administration via an implantable drug pump is an important potential mode of therapy in the treatment of osteomyelitis.
一种完全植入式药物泵作为一种给药系统用于治疗骨髓炎的效果得到了评估。将通过全身给药获得的兔血清和骨组织中的庆大霉素水平，与通过植入式药物泵局部给药获得的兔血清和骨组织中的庆大霉素水平进行了比较。全身给药时，庆大霉素的平均骨组织水平在每克低于1微克至3.6微克之间，而通过药物泵给药时，骨组织水平在每克10.8微克至64.0微克之间（微克=微克，即10^(-6)克）。为了评估药物泵作为一种治疗方式的效果，在10只兔子身上诱发了急性葡萄球菌性骨髓炎。在5只受感染的动物体内植入了装满阿米卡星的药物泵。其中3只在一周时培养结果为阴性。1只从药物泵中培养出少量葡萄球菌，1只从药物泵和伤口处均培养出少量细菌。临床上，这5只兔子在7天时均未表现出感染症状。其余5只兔子培养结果均为阳性，伤口处有大量葡萄球菌生长，临床上，所有兔子在7天时均表现出明显的感染症状。这些数据表明，通过植入式药物泵可以实现高局部和低全身抗生素水平，并且这种方法可以使受感染的肌肉骨骼伤口灭菌。因此，通过植入式药物泵给药是治疗骨髓炎的一种重要潜在治疗方式。
