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Microbial resistance related to antibiotic-loaded bone cement: a historical review

Lookup NU author(s): Dr Lucy Walker, Paul Baker, Dr Richard Holleyman, Professor David Deehan

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Abstract

© 2016 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) Purpose: The use of antibiotic-loaded bone cement (ALBC) has a range of indications for use in orthopaedics. It has the advantage of delivering high loads of antibiotics to a targeted site, thereby avoiding the side effects associated with systemic administration. However, there is concern that the use of ALBC may precipitate the development of antibiotic-resistant bacteria. Methods: This review focuses on (1) the published research using both animal and human models examining the association between ALBC and the induction of microbial resistance (2) the mechanisms by which antimicrobial resistance develop (3) the research pertaining to specific classes of antibiotics commonly used in orthopaedic practice (4) the recent developments in calcium sulphate beads, nanoparticles and chitosan, as alternative antimicrobial treatments for periprosthetic joint infections. Conclusion: The literature for and against a link between ALBC and the development of microbiological resistance is reviewed and presented. It is concluded that further research is needed to develop a defined set of indications for the use of ALBC in the management of periprosthetic joint infection. In addition, further research into alternative antimicrobial therapies in this area should be encouraged.


Publication metadata

Author(s): Walker LC, Baker P, Holleyman R, Deehan D

Publication type: Article

Publication status: Published

Journal: Knee Surgery, Sports Traumatology, Arthroscopy

Year: 2017

Volume: 25

Issue: 12

Pages: 3808-3817

Print publication date: 01/12/2017

Online publication date: 12/09/2016

Acceptance date: 31/08/2016

ISSN (print): 0942-2056

ISSN (electronic): 1433-7347

Publisher: Springer Verlag

URL: https://doi.org/10.1007/s00167-016-4309-5

DOI: 10.1007/s00167-016-4309-5


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