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Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_17 | Pages 44 - 44
1 Dec 2018
Stravinskas M Tarasevicius S Vitkauskiene A Nilsson M Lidgren L
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Aim

In vivo studies have shown a preventive and curative effect of using an injectable vancomycin containing biphasic ceramic in an osteomyelitis model. No clinical long term pharmacokinetic release study has been reported. Inadequate concentration in target tissues results in treatment failure and selection pressure for antibiotic-resistant organisms.

Our hypothesis was that vancomycin in the first week would reach high local concentrations but with low systemic levels.

Method

9 patients (6 women, 3 men) with trochanteric hip fractures classified as A1 and A2 according to the AO-classification all had internal fixations. The mean age was 75.3 years (± S.D. 12.3 years, range 44–84y). An injectable ceramic with hydroxyapatite embedded in a calcium sulphate matrix containing 66mg vancomycin per mL augmented the fixation. A mean of 9.7 mL (± S.D. 0.7 mL, range 8–10mL) was used. The elution of vancomycin was followed by collecting drain fluid, blood (4 days) and urine (4 weeks)