Voriconazole Admixed with PMMA-Impact on Mechanical Properties and Efficacy.
Candida spec
PMMA cement
efficacy
inhibition zone test
mechanical properties
voriconazole
Journal
Antibiotics (Basel, Switzerland)
ISSN: 2079-6382
Titre abrégé: Antibiotics (Basel)
Pays: Switzerland
ID NLM: 101637404
Informations de publication
Date de publication:
04 May 2023
04 May 2023
Historique:
received:
14
03
2023
revised:
25
04
2023
accepted:
27
04
2023
medline:
27
5
2023
pubmed:
27
5
2023
entrez:
27
5
2023
Statut:
epublish
Résumé
There are currently no recommendations to direct the optimal diagnosis and treatment of fungal osteoarticular infections, including prosthetic joint infections and osteomyelitis. Active agents (fluconazole; amphotericin B) are regularly applied per os or intravenously. Other drugs such as voriconazole are used less frequently, especially locally. Voriconazole is less toxic and has promising results. Local antifungal medication during primary surgical treatment has been investigated by implanting an impregnated PMMA cement spacer using intra-articular powder or by daily intra-articular lavage. The admixed dosages are rarely based on characteristic values and microbiological and mechanical data. The purpose of this in vitro study is to investigate the mechanical stability and efficacy of antifungal-admixed PMMA with admixed voriconazole at low and high concentrations. Mechanical properties (ISO 5833 and DIN 53435) as well as efficacy with inhibition zone tests with two Candida spp. were investigated. We tested three separate cement bodies at each measuring time ( Mixing voriconazole powder with PMMA (Polymethylmethacrylate) powder homogeneously is not easy because of the high amount of dry voriconazole in the powder formulation. Adding voriconazole (a powder for infusion solutions) has a high impact on its mechanical properties. Efficacy is already good at low concentrations.
Sections du résumé
BACKGROUND
BACKGROUND
There are currently no recommendations to direct the optimal diagnosis and treatment of fungal osteoarticular infections, including prosthetic joint infections and osteomyelitis. Active agents (fluconazole; amphotericin B) are regularly applied per os or intravenously. Other drugs such as voriconazole are used less frequently, especially locally. Voriconazole is less toxic and has promising results. Local antifungal medication during primary surgical treatment has been investigated by implanting an impregnated PMMA cement spacer using intra-articular powder or by daily intra-articular lavage. The admixed dosages are rarely based on characteristic values and microbiological and mechanical data. The purpose of this in vitro study is to investigate the mechanical stability and efficacy of antifungal-admixed PMMA with admixed voriconazole at low and high concentrations.
METHODS
METHODS
Mechanical properties (ISO 5833 and DIN 53435) as well as efficacy with inhibition zone tests with two Candida spp. were investigated. We tested three separate cement bodies at each measuring time (
CONCLUSIONS
CONCLUSIONS
Mixing voriconazole powder with PMMA (Polymethylmethacrylate) powder homogeneously is not easy because of the high amount of dry voriconazole in the powder formulation. Adding voriconazole (a powder for infusion solutions) has a high impact on its mechanical properties. Efficacy is already good at low concentrations.
Identifiants
pubmed: 37237751
pii: antibiotics12050848
doi: 10.3390/antibiotics12050848
pmc: PMC10215076
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Clin Orthop Relat Res. 2010 Aug;468(8):2101-6
pubmed: 20162384
J Antimicrob Chemother. 2020 Jan 1;75(1):140-148
pubmed: 31665417
Clin Microbiol Rev. 2014 Jan;27(1):68-88
pubmed: 24396137
Ann Clin Microbiol Antimicrob. 2021 Dec 31;20(1):86
pubmed: 34972536
Colloids Surf B Biointerfaces. 2019 Nov 1;183:110406
pubmed: 31401462
Orthop Rev (Pavia). 2015 Mar 09;7(1):5623
pubmed: 25874061
Int J Mol Sci. 2014 Feb 28;15(3):3640-59
pubmed: 24590126
Antibiotics (Basel). 2022 Jun 30;11(7):
pubmed: 35884133
Unfallchirurg. 2017 Jul;120(7):561-572
pubmed: 28643095
Biomedicines. 2022 Jul 29;10(8):
pubmed: 36009376
J Bone Joint Surg Br. 2012 Nov;94(11 Suppl A):42-6
pubmed: 23118379
Orthop Surg. 2021 Oct;13(7):2153-2162
pubmed: 34605610
Bone Joint Res. 2014 Aug;3(8):246-51
pubmed: 25104836
Int Orthop. 2020 Jan;44(1):15-22
pubmed: 31254016
Acta Orthop. 2013 Dec;84(6):517-23
pubmed: 24171675
Clin Orthop Relat Res. 2013 Jan;471(1):195-200
pubmed: 22782573
J Bone Jt Infect. 2021 Aug 23;6(7):321-328
pubmed: 34458074
J Bone Jt Infect. 2020 Mar 26;5(2):76-81
pubmed: 32454521
Orthopedics. 2011 Aug 08;34(8):e378-81
pubmed: 21815580
Med Mal Infect. 2012 Nov;42(11):567-8
pubmed: 23044087
Knee. 2018 Aug;25(4):631-637
pubmed: 29778657
Chin J Traumatol. 2022 Mar;25(2):63-66
pubmed: 35031203
J Fungi (Basel). 2022 Jul 29;8(8):
pubmed: 36012786
Microorganisms. 2022 Dec 28;11(1):
pubmed: 36677376
Proc Inst Mech Eng H. 2008 Apr;222(3):355-65
pubmed: 18491704
J Am Acad Orthop Surg. 2019 Sep 15;27(18):e804-e818
pubmed: 30520804
Clin Orthop Relat Res. 2011 Nov;469(11):3002-7
pubmed: 21638100
Bone Joint J. 2016 Nov;98-B(11):1534-1541
pubmed: 27803231
Clin Orthop Relat Res. 2009 Jul;467(7):1706-14
pubmed: 19224302
Radiologe. 2003 Sep;43(9):709-17
pubmed: 14517600
Orthopade. 2015 Dec;44(12):942-5
pubmed: 26572134
N Engl J Med. 2023 Jan 19;388(3):251-262
pubmed: 36652356
J Arthroplasty. 2013 Feb;28(2):374.e5-8
pubmed: 22810009
Diagnostics (Basel). 2022 Jun 30;12(7):
pubmed: 35885511