骨科植入型抗菌药物缓释系统局部释放情况的文献分析

Literature analysis of antibiotic elution from local antibiotic delivery systems

目的了解骨科植入型抗菌药物缓释系统局部释放情况。方法检索PubMed、Elsevier Science Direct、Embase、Springer Link、Wiley Online Library、CNKI、万方数据库,收集植入型抗菌药物缓释系统局部释放情况的研究,提取相关数据进行描述性统计分析,检索时限均从建库至2020年1月。结果共检索到骨科植入型抗菌药物缓释系统局部释放研究17项,其中预防研究2项、治疗研究15项,包括骨感染和假体周围感染治疗。植入型抗菌药物缓释系统负载的抗菌药物多为万古霉素、庆大霉素。不同缓释系统抗菌药物释放度不同,人工骨术后第1天局部释放抗菌药物浓度最高,人工骨混入2 g万古霉素,平均局部释放浓度可达1488. 33μg/mL。在治疗骨感染研究中,9项研究涉及应用骨科植入型抗菌药物缓释系统的转归,最低治愈率为95. 2%。结论骨科植入型抗菌药物缓释系统局部抗菌药物释放度高,是治疗骨科相关感染的有效手段。

Objective To understand the clinical characteristics of antibiotic elution from local antibiotic delivery systems. Methods PubMed,Elsevier Science Direct,Embase,Springer Link,Wiley Online Library,CNKI,Wanfang Data(to January 2020)were searched for the research of antibiotic elution from local antibiotic delivery systems. Data related to antibiotic elution from local antibiotic delivery systems were analyzed and descriptived. Results A total of seventeen research involved in antibiotic elution from local antibiotic delivery systems,two of them for prevention,and fifteen for treatment,including bone infections and periprosthetic infections. Vancomycin and gentamicin were the most loaded antibiotics in the local antibiotic delivery systems. Different kinds of antibiotics elution result from different local antibiotic delivery systems,artificial bone release the highest concentration of antibiotics after the first post-operative day,the antibiotic release concentration of the artificial bone with 2 g vancomycin can reach 1488. 33 μg/mL. In the treatment of orthopedic infections,nine studies involved the outcome of local antibiotic delivery systems,with a minimum cure rate of 95. 2%. Conclusion Antibiotic elution from local antibiotic delivery system is an effective method to treat orthopedic infection.