5 local antibiotics rfi

Local Antimicrobial Strategies in Fracture Related Infection H D Thai N V Nhuan 16 Sep 2023 – HCM city Pathophysiology of Osteomyelitis Pathophysiology of Osteomyelitis Bacteria OSTEOMYELITIS Necrotic Tissue Foreign Bodies Pathophysiology of Osteomyelitis Bacteria Irrigation Bacteria OSTEOMYELITIS Necrotic Tissue Foreign Bodies Debridement Delivery of Antibiotics Antibiotic characteristics for Local Use • Broad-spectrum antibiotic • Compatible with carrier • Adequate release • No deterioration of carrier streghth • Toxicity Local antibiotics and Recommended Local Dosages Minimum Dose Maximum Dose Toxicity Gentamicin 0.4 g 4.8 g Nephrotoxicity, ototoxicity Vancomycin 2g 6g Nephrotoxicity, neutropenia Tobramycin 1.2 g 4.8 g Nephrotoxicity, neurotoxicity 0.5 g + g 4.8 g + g Genta + Vanco Antibiotic – loaded carriers release Antibiotic – loaded carriers release Take home messages • Debridement is keystone before using local antimicrobial • Antibiotic: type, dosage, mixing method • PMMA: carrier for antibiotics – spacer, bead, coating