Elution of vancomycin, daptomycin, and amikacin from acrylic bone cement.
Elution of vancomycin, daptomycin, and amikacin from acrylic bone cement.
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从丙烯酸骨水泥中洗脱万古霉素、达托霉素和阿米卡星。
DOI：
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发表时间：
1991
影响因子：
4.2
通讯作者：
P. Noble
中科院分区：
文献类型：
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作者：
D. Kuechle;G. Landon;D. Musher;P. Noble
感染人工关节的细菌对抗生素的耐药性不断增加，这激发了人们将更有效的抗菌药物掺入聚甲基丙烯酸甲酯（PMMA）的兴趣。万古霉素和达托霉素对几乎所有葡萄球菌和链球菌都有效，而阿米卡星对革兰阴性杆菌的抗菌谱比庆大霉素等其他氨基糖苷类药物更广。这三种抗生素在掺入几种常用的PMMA制剂后仍保持生物活性，并容易洗脱到周围介质中。在负压下制备PMMA可降低孔隙率，使抗生素释放量减少50%；添加25%的葡聚糖可增加孔隙率，极大地促进了这些抗生素的洗脱。基于它们对革兰阳性菌和革兰阴性菌广泛的抗菌作用，在PMMA中加入万古霉素和阿米卡星值得进行临床研究。当结构完整性不重要，但需要显著的局部抗菌效果时，例如在使用含抗生素的珠子治疗骨髓炎时，将这些抗生素与葡聚糖一起添加到PMMA中可能是适用的。
Increasing antibiotic resistance of bacteria that infect prosthetic joints has stimulated interest in the incorporation of more effective antimicrobial agents into polymethylmethacrylate (PMMA). Vancomycin and daptomycin are effective against nearly all staphylococci and streptococci, and amikacin has a broader spectrum against gram-negative bacilli than do other aminoglycosides such as gentamicin. These three antibiotics maintained bioactivity after incorporation into several commonly used preparations of PMMA and eluted readily into the surrounding medium. Preparing PMMA under negative atmospheric pressure, which decreases porosity, caused a 50% reduction in antibiotic release; the addition of 25% dextran, which increases porosity, greatly facilitated elution of these antibiotics. Based on their broad antibacterial effect against gram-positive and gram-negative bacteria, inclusion of vancomycin and amikacin in PMMA merits clinical study. The addition of these antibiotics to PMMA, together with dextran, may be applicable when structural integrity is unimportant but a substantial local antimicrobial effect is desired, such as in the use of antibiotic-containing beads to treat osteomyelitis.