Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection
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 rep...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/3/336 |
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| author | Carlos D. Pargas Ahmed H. Elhessy Mehdi Abouei Martin G. Gesheff Janet D. Conway |
| author_facet | Carlos D. Pargas Ahmed H. Elhessy Mehdi Abouei Martin G. Gesheff Janet D. Conway |
| author_sort | Carlos D. Pargas |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T20:12:28Z |
| format | Article |
| id | doaj.art-3fa6329455fe42b7b5b989ca5a503730 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T20:12:28Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-3fa6329455fe42b7b5b989ca5a5037302023-11-24T00:10:52ZengMDPI AGAntibiotics2079-63822022-03-0111333610.3390/antibiotics11030336Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue InfectionCarlos D. Pargas0Ahmed H. Elhessy1Mehdi Abouei2Martin G. Gesheff3Janet D. Conway4International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USAInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USAInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USAInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USAInternational Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, USALocal 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.https://www.mdpi.com/2079-6382/11/3/336acute kidney injurycalcium sulfatecreatininePMMAsafetytobramycin |
| spellingShingle | Carlos D. Pargas Ahmed H. Elhessy Mehdi Abouei Martin G. Gesheff Janet D. Conway Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection Antibiotics acute kidney injury calcium sulfate creatinine PMMA safety tobramycin |
| title | Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection |
| title_full | Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection |
| title_fullStr | Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection |
| title_full_unstemmed | Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection |
| title_short | Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection |
| title_sort | tobramycin blood levels after local antibiotic treatment of bone and soft tissue infection |
| topic | acute kidney injury calcium sulfate creatinine PMMA safety tobramycin |
| url | https://www.mdpi.com/2079-6382/11/3/336 |
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