title: Prevention of infection with tobramycin-containing bone cement or systemic cefazolin in an animal model.
abstract: We investigated in an animal model the efficacy of tobramycin-containing bone cement and systemic cefazolin for infection prophylaxis. In 18 female rabbits, the femoral cavity was inoculated with Staphylococcus aureus before injection of bone cement. The first group of six rabbits received tobramycin-containing Simplex-P bone cement. Two other groups of six rabbits received plain Simplex-P bone cement. Preoperatively, in one of the two latter groups cefazolin was administered intravenously. The other group served as untreated controls. The rabbits were monitored for clinical signs of infection. At 7 days' follow-up, the femora were harvested and cultures from the bone adjacent to the cement plug were quantified. Cultures from the rabbits which received antibiotic prophylaxis (either cefazolin systemically or tobramycin-containing bone cement) were all negative. In contrast, all rabbits in the untreated control group had positive cultures. These rabbits also had other signs of infection such as an elevated erythrocyte sedimentation rate and loss of body weight. Culture results were confirmed by the absence of bacterial DNA in the polymerase chain reaction hybridization assay. In conclusion, we found that both tobramycin-containing bone cement and systemic cefazolin are effective in preventing implant bed infection in rabbits up to 7 days after contamination with S. aureus.
authors.affiliation: Department of Orthopaedics, G05.228, University Medical Center Utrecht, PO Box 85500, NL 3508 GA Utrecht, The Netherlands. m.nijhof@chir.azu.nl
authors.forename: M W
authors.initials: MW
authors.lastname: Nijhof
authors.forename: H P
authors.initials: HP
authors.lastname: Stallmann
authors.forename: H C
authors.initials: HC
authors.lastname: Vogely
authors.forename: A
authors.initials: A
authors.lastname: Fleer
authors.forename: L M
authors.initials: LM
authors.lastname: Schouls
authors.forename: W J
authors.initials: WJ
authors.lastname: Dhert
authors.forename: A J
authors.initials: AJ
authors.lastname: Verbout
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001170:Arthritis, Infectious / Q000382:microbiology / Q000517:prevention & control*; D001799:Blood Sedimentation; D001843:Bone Cements / Q000737:chemistry*; D002437:Cefazolin / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D002511:Cephalosporins / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis; D004353:Drug Evaluation, Preclinical; D005260:Female; D005269:Femur / Q000382:microbiology / Q000601:surgery; D007275:Injections, Intravenous; D008422:Materials Testing; D020366:Methylmethacrylate / Q000737:chemistry*; D023421:Models, Animal; D016133:Polymerase Chain Reaction; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000517:prevention & control*; D011817:Rabbits; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D014031:Tobramycin / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D015431:Weight Loss
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D002511:Cephalosporins; D004269:DNA, Bacterial; D020366:Methylmethacrylate; D002437:Cefazolin; D014031:Tobramycin