Streptomycin-loaded bone cement in the treatment of tuberculous osteomyelitis: an adjunct to conventional therapy.
Streptomycin-loaded bone-cement (7 g of streptomycin in 40 g of bone cement) beads were used in the treatment of tuberculous bursitis and osteomyelitis of the greater trochanter in a 76-year-old woman. Wound drainage, serum and urine concentrations of streptomycin were measured. For the first 96 hours, the streptomycin levels in the wound drainage ranged from 2932 mg/L to 414.4 mg/L, and in the serum, streptomycin levels ranged from 1.7 mg/L to 13.7 mg/L. The patient recovered without complication and at follow-up 2 years later was free of infection and walking without pain. The authors conclude that the use of streptomycin-loaded bone cement can safely and effectively eradicate mycobacterial tuberculosis osteomyelitis.
Masri
B A
BA
Department of Orthopaedics, Vancouver Hospital and Health Sciences Centre, BC.
Duncan
C P
CP
Jewesson
P
P
Ngui-Yen
J
J
Smith
J
J
D000368:Aged; D001843:Bone Cements; D017024:Chemotherapy, Adjuvant; D004343:Drug Implants; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D020366:Methylmethacrylate; D008768:Methylmethacrylates; D010019:Osteomyelitis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D011859:Radiography; D013307:Streptomycin / Q000008:administration & dosage* / Q000032:analysis; D014394:Tuberculosis, Osteoarticular / Q000150:complications / Q000188:drug therapy* / Q000601:surgery
D001843:Bone Cements; D004343:Drug Implants; D008768:Methylmethacrylates; D020366:Methylmethacrylate; D013307:Streptomycin