دورية أكاديمية
Review of Intra-Articular Use of Antibiotics and Antiseptic Irrigation and Their Systematic Association with Chondrolysis.
العنوان: | Review of Intra-Articular Use of Antibiotics and Antiseptic Irrigation and Their Systematic Association with Chondrolysis. |
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المؤلفون: | Post HK; Department of Orthopedic Surgery and Sports Medicine, University of Kansas School of Medicine, Kansas City, KS., Blankespoor MG; Department of Orthopedic Surgery and Sports Medicine, University of Kansas School of Medicine, Kansas City, KS., Ierulli VK; Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA., Morey TD; Department of Orthopedic Surgery and Sports Medicine, University of Kansas School of Medicine, Kansas City, KS., Schroeppel JP; Department of Orthopedic Surgery and Sports Medicine, University of Kansas School of Medicine, Kansas City, KS., Mulcahey MK; Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL., Vopat BG; Department of Orthopedic Surgery and Sports Medicine, University of Kansas School of Medicine, Kansas City, KS., Vopat ML; Department of Orthopedic Surgery and Sports Medicine, University of Kansas School of Medicine, Kansas City, KS. |
المصدر: | Kansas journal of medicine [Kans J Med] 2023 Oct 30; Vol. 16, pp. 272-276. Date of Electronic Publication: 2023 Oct 30 (Print Publication: 2023). |
نوع المنشور: | Journal Article; Review |
اللغة: | English |
بيانات الدورية: | Publisher: The University of Kansas Medical Center Country of Publication: United States NLM ID: 101581958 Publication Model: eCollection Cited Medium: Print ISSN: 1948-2035 (Print) Linking ISSN: 19482035 NLM ISO Abbreviation: Kans J Med Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: Kansas City, KS : The University of Kansas Medical Center |
مستخلص: | Introduction: Intra-articular antibiotics have been proposed as a treatment for septic arthritis to allow for high local concentrations without subjecting a patient to the toxicity/side effects of systemic therapy. However, there is concern for chondrotoxicity with intra-articular use of these solutions in high concentrations. The purpose of this systematic review was to evaluate the intra-articular use of antibiotics and antiseptic solutions, and to determine their association with chondrolysis following in vitro or in vivo administration. Methods: A systematic review was conducted following PRISMA guidelines through PubMed, Clinical Key, OVID, and Google Scholar. Studies in English were included if they evaluated for chondrotoxicity following antibiotic exposure. Results: The initial search resulted in 228 studies, with 36 studies meeting criteria. These 36 studies included manuscripts that studied 24 different agents. Overall, 7 of the 24 (29%) agents were non-chondrotoxic: minocycline, tetracycline, chloramphenicol, teicoplanin, pefloxacin, linezolid, polymyxin-bacitracin. Eight (33%) agents had inconsistent results: doxycycline, ceftriaxone, gentamicin, vancomycin, ciprofloxacin, ofloxacin, chlorhexidine, and povidone iodine. Chondrotoxicity was evident with 9 (38%) agents, all of which were also dose-dependent chondrotoxic based on reported estimated half maximal inhibitory concentrations (est. IC50): amikacin (est. IC50 = 0.31-2.74 mg/mL), neomycin (0.82), cefazolin (1.67-3.95), ceftazidime (3.16-3.59), ampicillin-sulbactam (8.64 - >25), penicillin (11.61), amoxicillin (14.01), imipenem (>25), and tobramycin (>25). Additionally, chondroprotective effects of doxycycline and minocycline were reported. Conclusions: This systematic review identified agents that may be used in the treatment of septic arthritis. Nine agents should be avoided due to their dose-dependent chondrotoxic effects. Further studies are needed to clarify the safety of these medications for human intra-articular use. (© 2023 The University of Kansas Medical Center.) |
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فهرسة مساهمة: | Keywords: chondrotoxicity; intra-articular antibiotics; joint infection; septic arthritis |
تواريخ الأحداث: | Date Created: 20231113 Latest Revision: 20231122 |
رمز التحديث: | 20231123 |
مُعرف محوري في PubMed: | PMC10635690 |
DOI: | 10.17161/kjm.vol16.20357 |
PMID: | 37954883 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1948-2035 |
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DOI: | 10.17161/kjm.vol16.20357 |