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Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_10 | Pages 27 - 27
1 Oct 2022
RIFAMPICIN DOES NOT REDUCE MOXIFLOXACIN TISSUE CONCENTRATIONS FOLLOWING ONE-STAGE REVISION IN A PORCINE MODEL OF IMPLANT-ASSOCIATED OSTEOMYELITIS
Vittrup S Jensen LK Hanberg P Slater J Hvistendahl MA Stilling M Jørgensen N Bue M
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Aim

This study investigated if co-administration of rifampicin with moxifloxacin led to a decrease in moxifloxacin concentrations in relevant tissues in a porcine model of implant-associated osteomyelitis caused S. aureus. Pharmacokinetics were measured using microdialysis and treatment effect was measured by quantifying bacterial load from implant and periprosthetic bone following a 1-stage revision and antibiotics.

Method

15 female pigs received a stainless-steel implant in the right proximal tibia and were randomized into two groups. Infection was introduced by inoculating the implant with Staphylococcus aureus as previously described1. On day 7 post surgery, all pigs were revised with implant removal, debridement of implant cavity and insertion of a sterile implant. 7 days of treatment was then initiated with either moxifloxacin 400 mg iv q.d. (M) or moxifloxacin and rifampicin 450 mg iv b.i.d. (RM). At day 14, animals were sedated and microdialysis was applied for continuous sampling of moxifloxacin concentrations during 8 h in five compartments: the implant cavity, cancellous bone in both the infected and non-infected proximal tibia, and adjacent subcutaneous tissue on both the infected and non-infected side using a previously described setup2. Venous blood samples were collected. Implant and adjacent bone were removed for analysis.

Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_10 | Pages 17 - 17
1 Oct 2022
TIBIAL BONE AND SOFT-TISSUE CONCENTRATIONS FOLLOWING COMBINATION THERAPY WITH VANCOMYCIN AND MEROPENEM: EVALUATED BY MICRODIALYSIS IN A PORCINE MODEL. SHOULD PATIENTS WITH OPEN FRACTURES HAVE HIGHER DOSES OF ANTIBIOTICS?
Vittrup S Hanberg P Knudsen MB Tøstesen S Kipp JO Hansen J Jørgensen NP Stilling M Bue M
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Aim

Prompt and sufficient broad spectrum empirical antibiotic treatment is key to prevent infection following open tibial fractures. Succeeding co-administration, we dynamically assessed the time for which vancomycin and meropenem concentrations were above relevant epidemiological cut-off minimal inhibitory concentrations (T>MIC) in tibial compartments for the bacteria most frequently encountered in open fractures. Low and high MIC-targets were applied: 1 and 4 µg/mL for vancomycin and 0.125 and 2 µg/mL for meropenem.

Materials and methods

8 pigs received a single dose of 1000 mg vancomycin and 1000 mg meropenem simultaneously over 100 min and 10 min, respectively. Microdialysis catheters were placed for sampling over 8 h in tibial cancellous bone, cortical bone, and adjacent subcutaneous adipose tissue. Venous blood samples were collected as references.

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