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SHR Neuro Krebs Kardio Lipid

Kühn, KD; Renz, N; Trampuz, A.
[Local antibiotic therapy].
Unfallchirurg. 2017; 120(7):561-572 [OPEN ACCESS]
Web of Science PubMed FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Kühn Klaus-Dieter
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Abstract:
The treatment of superficial wound infections with local antibiotics is considered to be problematic as it is accompanied by an increased risk of resistance development and ineffectiveness in deeper regions. On the contrary, the local application of antibiotics is useful in arthroplasty and necessary if implants are utilized. The reason for this is the prevention of a rapid biofilm formation on foreign implants and a resulting infection may remain undiscovered until it becomes chronic. Apart from exogenous material, necrotic tissue (e. g. bone sequestra) provides suitable retreat areas for pathogens in the body. Because of the characteristics of bone and joint infections and an exceptional infection recurrence rate, a combined approach is required. Systemic antibiotic prophylaxis is able to reduce the number of pathogens acquired by perioperative contamination or hematogenic spread from another focus of infection; however, systemically applied antibiotics often fail to form an effective colonization barrier around the implant because their ability to penetrate the bone is relatively low. On the other hand, the high concentration of locally released antibiotics leads to an effective protection of the implant from bacteria in situ. Thus, for the treatment of implant-associated infections, systemic and local application of anti-infective agents is a reliable adjuvant measure that improves the therapeutic success. Polymethylmethacrylate (PMMA) bone cement is the most commonly used local drug carrier. Based on clinical and microbiological results, microbiologists and infectious disease experts together with the surgeon and pharmacist determine which anti-infective agents are indicated for systemic and local, PMMA cement-related application. Because there is no evident concept for the local application, unlike the recommendation for systemic use of anti-infective agents, this review article describes which aspects should be taken into account.
Find related publications in this database (using NLM MeSH Indexing)
Administration, Topical -
Anti-Bacterial Agents - administration & dosage
Antibiotic Prophylaxis -
Arthroplasty -
Arthroplasty, Replacement -
Biofilms - drug effects
Drug Carriers -
Drug Therapy, Combination -
Humans -
Polymethyl Methacrylate -
Prosthesis-Related Infections - drug therapy
Surgical Wound Infection - drug therapy
Wound Infection - drug therapy

Find related publications in this database (Keywords)
PMMA cement
Biofilm
Colonization barrier
Manual application
Recommendations
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