Local antibiotic delivery vehicles in the treatment of musculoskeletal infection
Local antibiotic delivery vehicles in the treatment of musculoskeletal infection
复制标题
DOI：
10.1097/01.blo.0000175713.30506.77
复制
发表时间：
2005-08-01
影响因子：
4.2
通讯作者：
Hanssen, AD
中科院分区：
文献类型：
--
作者：
Hanssen, AD
使用局部抗生素递送载体实现的主要益处是能够获得极高水平的局部抗生素而不增加全身毒性。抗生素骨水泥代表了骨科手术中抗生素递送载体的当前标准。骨水泥的生物可降解替代品也正在临床上使用，并且有许多新产品处于积极的开发阶段。这些替代品可分为骨移植物、骨移植替代品或扩展剂、天然聚合物（蛋白质基产品）和合成聚合物。复合生物材料，同时提供可变的抗生素输送模式的功能，也有助于骨再生的过程代表了最理想的一类局部抗生素输送车辆。高浓度的某些抗生素已被证明会以剂量依赖性反应对正常骨再生过程产生不利影响。仍然需要进行大量的调查来确定局部使用抗生素的正确使用，以在消除感染而不过度抑制骨再生过程之间取得平衡。
The primary benefit achieved with local antibiotic delivery vehicles is the ability to obtain extremely high levels of local antibiotics without increasing systemic toxicity. Antibiotic-loaded bone cement represents the current standard as an antibiotic delivery vehicle in orthopaedic surgery. Biodegradable alternatives to antibiotic-loaded bone cement also are being used clinically and there are many new products in the active stages of development. These alternatives can be categorized as bone graft, bone graft substitutes or extenders, natural polymers (protein-based products), and synthetic polymers. Composite biomaterials that simultaneously provide the functions of variable antibiotic delivery patterns and also contribute to the process of bone regeneration represent the most ideal class of local antibiotic delivery vehicles. High concentrations of certain antibiotics have been shown to affect the process of normal bone regeneration adversely in a dose dependent response. Considerable investigation still is required to determine the proper use of locally administered antibiotics to negotiate the balance between eradicating infection without excessively inhibiting the processes of bone regeneration.