Document Detail


Use of vancomycin and tobramycin polymethylmethacrylate impregnated beads in the management of chronic osteomyelitis.
MedLine Citation:
PMID:  3293958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Over the past several years there has been a growing interest in the use of locally implanted beads containing antibiotics for the treatment of chronic osteomyelitis. This method has been popularized in Europe and, with few exceptions, gentamicin has been the only antibiotic used. There have been only a few reports from the U.S. and there is little information regarding the pharmacokinetics of antibiotics used in this fashion. To our knowledge this is the first report using vancomycin. Three patients with chronic osteomyelitis were treated with vancomycin and/or tobramycin polymethylmethacrylate beads. These beads were extemporaneously compounded and implanted for up to six weeks. From the site of bead implantation local fluid aliquots were collected for the measurement of antibiotic concentrations. In two patients, initial tobramycin concentrations exceeded 400 mg/L. In one patient receiving vancomycin, initial localized concentrations were approximately 100 mg/L. In all three patients therapeutic concentrations of localized antibiotic were maintained with immeasurable systemic concentrations throughout the period of bead placement. Localized antibiotic therapy for the management of chronic osteomyelitis represents a potential therapeutic alternative to long-term parenteral therapy. Data presented here suggest that other antibiotics, such as vancomycin and tobramycin, can be used successfully in polymethylmethacrylate beads and provide preliminary facts for future investigations of such applications.
Authors:
D M Scott; J C Rotschafer; F Behrens
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Drug intelligence & clinical pharmacy     Volume:  22     ISSN:  0012-6578     ISO Abbreviation:  Drug Intell Clin Pharm     Publication Date:  1988 Jun 
Date Detail:
Created Date:  1988-09-01     Completed Date:  1988-09-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0212457     Medline TA:  Drug Intell Clin Pharm     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  480-3     Citation Subset:  IM    
Affiliation:
College of Pharmacy, University of Nebraska, Omaha.
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MeSH Terms
Descriptor/Qualifier:
Adult
Chronic Disease
Female
Fluorescent Antibody Technique
Humans
Male
Methylmethacrylates
Osteomyelitis / drug therapy*,  microbiology
Spectrometry, Fluorescence
Tobramycin / administration & dosage,  therapeutic use*
Vancomycin / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Methylmethacrylates; 1404-90-6/Vancomycin; 32986-56-4/Tobramycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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