The pharmacodynamic and pharmacokinetic characteristics of antimicrobial agents are the two fundamental pharmacological components which provide a rational for the choice of therapy for skin and skin structure infections, and especially serious infections. The most important PK-PD parameters are well known which can potentiate therapeutic efficacy. Antimicrobial agents ca be subdivided into categories based on whether their activity is dependent on concentration or exposure time. Therefore, a correct dosing regimen for the time-dependent molecules (i.e. beta-lactams, linezolid, tigecycline) should prolong the maximum exposure time to maintain serum levels over the minimum inhibitory concentration (MIC). The concentration-dependent molecules, on the other hand, which include aminoglycosides and fluoroquinolones, should be given in order to reach maximum concentrations, since they are bactericidal in direct proportion to their concentrations and possess a prolonged post-antibiotic effect.
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Brucellosis, caused by a facultative intracellular gram-negative coccobacillus, is one of the most common zoonotic infections worldwide. Very rarely, brucellosis can cause periprosthetic joint infections (PJI). In this case-based literature review, we summarize the current medical literature regarding Brucella PJI, with the aim to raise awareness among clinicians, particularly in non-endemic areas.
View Article and Find Full Text PDFActa Orthop Belg
December 2024
Chryseobacterium indologenes is a rare human pathogen which is nowadays considered an emerging fearsome organism because of its upcoming antibiotic resistance. We present a quite unique case of a multi drug resistant C. indologenes surgical wound infection in a patient submitted to cannulated screw fixation of a displaced medial malleolus fracture.
View Article and Find Full Text PDFCarbon fibre reinforced polyetheretherketone (CFR-PEEK) implants have gained interest because of reported biomechanical advantages and radio-lucent properties. The aim of this study was to evaluate the role of CFR-PEEK nails in patients with metastatic bone disease (MBD). We performed a retrospective cohort study evaluating patients with MBD undergoing intramedullary (IM) nailing for prophylaxis or fixation of pathological fractures using CFR- PEEK or titanium implants.
View Article and Find Full Text PDFCorrect treatment of chronic osteomyelitis depends on proper identification of the bone-infecting microorganism, but it is difficult identify the specific etiology in previously treated patients and in those with implants. Small colony variants auxotrophyc for menadione had been related with false-negative results in culture of patient with chronic osteomyelitis, but menadione supplementation can increase bone culture performance. The purpose was to evaluate the effect of menadione supplementation on isolates in bone cultures, in a cohort of patients with osteomyelitis, Medellín- Colombia.
View Article and Find Full Text PDFThe concept of Debridement, Antibiotics and Implant Retention (DAIR) is well known in periprosthetic joint infections. Extrapolating this concept to fracture related infections is mired in controversies. Characteristics of the metal implant, duration of infection, state of fracture healing, microbiological profile etc.
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