The Discovery Void
Updated: Jun 18
Surgical site infection is a common complication after foot and ankle surgery, and antimicrobial resistance is on the rise.
The calls for better antibiotic stewardship are growing louder, prophylactic antibiotics have been shown to lack efficacy, and poly-methyl-methacrylate antibiotic loaded spacers are known to contribute to resistance, with recurrent infection rates reported between 10% to 45%.
There has not been a new class of antibiotics introduced in more than 30 years, and newer drugs are already facing resistance from common microorganisms.
So far, many of the organisms are common actors, and alternative drug combinations have shown efficacy.
But, what if the bad actors with few antibiotic susceptibilities were to acquire the resistance mechanisms? What would or could we do?
An alternative approach has been tested in Europe using an absorbable, gentamycin-loaded, calcium sulphate/hydroxyapatite bio-composite filler. The results from short-, mid-, and long-term follow-up have been promising, and the FDA has recently approved it for use in the United States.
The carrier provides an absorbable scaffold that allows for a burst reaction which is more than 100 times the minimum inhibitory concentrations for commonly encountered actors. This reaction prevents antimicrobial resistance and systemic complications while allowing for rapid dissolution.
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