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Teicoplanin in the prevention of infection in total hip replacement.

Abstract
Perioperative antibiotic prophylaxis has been shown to be effective in reducing postoperative wound infections. The rising incidence of infections secondary to methicillin-resistant strains of Staphylococcus aureus. S. epidermidis and S. enterococcal prompted us to administer Teicoplanin to infection in elective total joint arthroplasty. In 111 patients Teicoplanin was given in a single intravenous dose of 10 mg/kg prior to surgery. In the postoperative period no deep infection of the prosthetic device was found in a 14-month follow-up. In two patients the following organisms were isolated from superficial infections of the wound: S. epidermidis (methicillin-sensitive), Pseudomonas aeruginosa, and Enterobacter sp. In no patient was revision surgery necessary. The serum concentration of Teicoplanin was within the therapeutic range during surgery, and tissue levels of Teicoplanin in cancellous (6.2 mg/kg, range 3.8-10.9 mg/kg) and cortical (7.1 mg/kg, range 2.6-12.1 mg/kg) bone during surgery in 16 patients exceeded the minimum inhibitory concentration of 90% (MIC90) of methicillin-resistant strains reported for methicillin-resistant strains. In our experience a single dose regimen of Teicoplanin is a safe and effective method of antibiotic prophylaxis in hip joint replacement, particularly when methicillin-resistant bacteria are present.
AuthorsS Nehrer, F Thalhammer, E Schwameis, S Breyer, R Kotz
JournalArchives of orthopaedic and trauma surgery (Arch Orthop Trauma Surg) Vol. 118 Issue 1-2 Pg. 32-6 ( 1998) ISSN: 0936-8051 [Print] Germany
PMID9833102 (Publication Type: Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Teicoplanin
Topics
  • Acetabulum (chemistry, pathology)
  • Aged
  • Anti-Bacterial Agents (analysis, pharmacokinetics, therapeutic use)
  • Antibiotic Prophylaxis
  • Arthroplasty, Replacement, Hip
  • Biopsy
  • Drug Evaluation
  • Female
  • Femur (chemistry, pathology)
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal (chemistry, pathology)
  • Prospective Studies
  • Surgical Wound Infection (epidemiology, prevention & control)
  • Teicoplanin (analysis, pharmacokinetics, therapeutic use)
  • Tissue Distribution

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