Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection

Antibiotics

卷:11

Mehdi Abouei¹  Ahmed H. Elhessy¹  Martin G. Gesheff¹  Carlos D. Pargas¹  Janet D. Conway¹ 

[1] International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA;

关键词: acute kidney injury;    calcium sulfate;    creatinine;    PMMA;    safety;    tobramycin;   

DOI  :  10.3390/antibiotics11030336

来源: DOAJ

【 摘 要 】

Local antibiotic delivery using different carriers plays an important role in both infection prophylaxis and treatment. Besides dead space management, these carriers have the advantage of providing a high concentration of local antibiotics with a lower risk of systemic toxicity. Few studies have reported on systemic toxicity associated with antibiotic-impregnated carriers. The present study investigates the systemic tobramycin concentration at 24, 48 and 72 h postoperatively after using tobramycin-loaded polymethyl methacrylate (PMMA) and calcium sulfate (CS) as local antibiotic carriers. Additionally, this work assesses the renal function postoperatively for indications of acute kidney injury (AKI). Fifty-two patients were treated in 58 procedures with tobramycin and vancomycin-loaded PMMA, CS, or both. All systemic tobramycin levels were <2 mcg/mL at 72 h, and the resulting rate of AKI was 12% (7/58). In conclusion, local tobramycin antibiotic delivery using PMMA, CS, or both remains a safe and effective modality in the treatment of osteomyelitis as long as the surgeon is aware of its possible nephrotoxic effect.

【 授权许可】

Unknown