Calcium Sulfate as a Local Antibiotic Delivery Vehicle in Chronic Osteomyelitis Following Internal Fixation: A Prospective Case Series.

IF 1 Q4 PHARMACOLOGY & PHARMACY
Mohammed Jaffer Jawad, Raed Abbas Saadoon, Wassan Nori Mohammed Hassan
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引用次数: 0

Abstract

Introduction: Chronic osteomyelitis is a complex and persistent orthopedic infection. Antibiotic-loaded calcium sulfate (CS) has promoted the eradication of infection and bone regeneration. To evaluate the early and mid-term clinical outcomes of antibiotic-impregnated CS in the management of chronic osteomyelitis following internal fixation.

Methods: A prospective interventional case series included (n=15) patients with chronic osteomyelitis treated at Al Yarmouk Teaching Hospital. The patient's medical, surgical history, Additionally, patients' and physical examination were recorded. inflammatory markers and microbiological culture from sinus discharge. Imaging was performed to classify the type of infection according to the Cierny and Mader classification. All patients underwent extensive surgical debridement and implantation of CS loaded with vancomycin or tobramycin, and systemic antibiotics were administered according to culture results. Patients were followed up for 1 year to assess functional scores and infection eradication.

Results: The mean age was 36.86±9.41 years, with 66.7% male and 33.3% female. Tibia was involved in (46.7%). Methicillin-Resistant Staphylococcus Aureus was isolated in (66.67%) of all cases. After a one-year follow-up, all cases achieved infection resolution. Functional scores improved significantly, from 26.8 to 64.2 (P < 0.001).

Discussion: Antibiotic-loaded CS as an adjuvant to surgical debridement and systemic antibiotics shows promising results with higher rates of infection eradication and significant functional improvement.

Conclusions: Using CS loaded with antibiotics as complementary therapy with systemic antibiotics demonstrated significant infection control and functional recovery in patients with chronic osteomyelitis following internal fixation during the early and mid-term follow up. Future studies need a larger sample and a longer follow up.

硫酸钙作为慢性骨髓炎内固定后局部抗生素递送载体:前瞻性病例系列。
慢性骨髓炎是一种复杂而持久的骨科感染。抗生素负载硫酸钙(CS)促进了感染的根除和骨再生。目的评价抗生素浸渍CS治疗内固定后慢性骨髓炎的早期和中期临床效果。方法:前瞻性介入病例系列包括(n=15)在Al Yarmouk教学医院治疗的慢性骨髓炎患者。记录患者的病史、手术史,并记录患者的体格检查。鼻窦分泌物的炎症标志物和微生物培养。影像学检查根据Cierny和Mader分类对感染类型进行分类。所有患者均进行了广泛的手术清创,并植入装有万古霉素或妥布霉素的CS,并根据培养结果给予全身抗生素治疗。患者随访1年,评估功能评分和感染根除情况。结果:平均年龄36.86±9.41岁,男性占66.7%,女性占33.3%。胫骨受累(46.7%)。66.67%的病例检出耐甲氧西林金黄色葡萄球菌。经过一年的随访,所有病例均获得感染解决。功能评分从26.8分显著提高到64.2分(P < 0.001)。讨论:载抗生素的CS作为外科清创和全身抗生素的辅助,具有较高的感染根除率和显着的功能改善,具有良好的效果。结论:在慢性骨髓炎患者内固定后的早期和中期随访中,使用CS加载抗生素作为全身抗生素的补充治疗,可显著控制感染和功能恢复。未来的研究需要更大的样本和更长时间的随访。
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来源期刊
Reviews on recent clinical trials
Reviews on recent clinical trials PHARMACOLOGY & PHARMACY-
CiteScore
3.10
自引率
5.30%
发文量
44
期刊介绍: Reviews on Recent Clinical Trials publishes frontier reviews on recent clinical trials of major importance. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: important Phase I – IV clinical trial studies, clinical investigations at all stages of development and therapeutics. The journal is essential reading for all researchers and clinicians involved in drug therapy and clinical trials.
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