不含抗生素的抗菌聚(甲基丙烯酸甲酯)骨水泥:最新进展综述。

Gladius Lewis
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引用次数: 0

摘要

人工关节感染(PJI)是全关节成形术后最严重的并发症,因为它与高发病率和低生活质量等因素相关,而且难以预防,治疗/管理起来也极具挑战性。众所周知,抗生素载体聚甲基丙烯酸甲酯(PMMA)骨水泥(ALBC)作为一种预防和治疗/管理 PJI 的药物存在许多缺点。其一是导致大多数 PJI 病例的微生物(如耐甲氧西林金黄色葡萄球菌)已经或正在对硫酸庆大霉素产生抗药性,而庆大霉素是绝大多数已获批准的 ALBC 品牌中的抗生素。因此,许多研究人员努力开发不含庆大霉素(或任何抗生素)但具有出色抗菌效果的水门汀。关于这些所谓的 "不含抗生素的抗菌 "PMMA 骨水泥(AFAMBCs),已有大量文献报道。本研究对这些文献进行了全面的批判性综述。除了总结 AFAMBCs 特征研究结果的主要趋势外,还强调了文献的吸引人之处和不足之处。不足之处为今后的工作提供了动力,其中一些想法是通过在基础水泥的粉末和/或液体中分别添加纳米结构材料和/或天然产品提取物来配制新一代 AFAMBC。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antibiotic-free antimicrobial poly (methyl methacrylate) bone cements: A state-of-the-art review.

Prosthetic joint infection (PJI) is the most serious complication following total joint arthroplasty, this being because it is associated with, among other things, high morbidity and low quality of life, is difficult to prevent, and is very challenging to treat/manage. The many shortcomings of antibiotic-loaded poly (methyl methacrylate) (PMMA) bone cement (ALBC) as an agent for preventing and treating/managing PJI are well-known. One is that microorganisms responsible for most PJI cases, such as methicillin-resistant S. aureus, have developed or are developing resistance to gentamicin sulfate, which is the antibiotic in the vast majority of approved ALBC brands. This has led to many research efforts to develop cements that do not contain gentamicin (or, for that matter, any antibiotic) but demonstrate excellent antimicrobial efficacy. There is a sizeable body of literature on these so-called "antibiotic-free antimicrobial" PMMA bone cements (AFAMBCs). The present work is a comprehensive and critical review of this body. In addition to summaries of key trends in results of characterization studies of AFAMBCs, the attractive features and shortcomings of the literature are highlighted. Shortcomings provide motivation for future work, with some ideas being formulation of a new generation of AFAMBCs by, example, adding a nanostructured material and/or an extract from a natural product to the powder and/or liquid of the basis cement, respectively.

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