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Vancomycin plus gentamicin-loaded spacers associated with higher microbiological eradication
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PRAGUE — Compared with use of gentamicin-loaded spacers, vancomycin plus gentamicin-loaded spacers were significantly associated with a higher microbiological eradication and a trend toward higher infection control, according to a presenter here.
“[Vancomycin] and gentamicin-loaded spacers can be a valuable option,” Tiago Frada, of the University of Minho, Braga, Portugal, said during his presentation at the 16th EFORT Congress. “Our results demonstrate they are associated with higher microbiological eradication, and they show an important trend toward higher healing than gentamicin-alone spacers.”
Tiago Frada
Frada and colleagues retrospectively reviewed 146 patients (54% women) with periprosthetic joint infections, of whom 83 received gentamicin-loaded spacers and 63 received vancomycin plus gentamicin-loaded spacers. The main outcome variables studied were microbiological eradication in the second stage and infection control after the second stage.
Results showed no statistical differences in sex, age, BMI, time with spacer, type of infection or the isolation of gram-positive or gram-negative bacteria among groups.
“What we did find is statistically significant differences in second-stage positive cultures,” Frada said. “The percentages of the second-stage positive cultures [were] 23% in gentamicin group and 6% in [vancomycin] plus gentamicin group.”
Frada noted, at more than 4.5 years follow-up, the achievement of a global rate of infection control of 75%. According to study results, 84% infection control was observed for chronic infection vs. 60% for acute infections, and negative cultures had infection control of 81% vs. 39% with positive cultures. Additionally, infection control was superior in the vancomycin plus gentamicin group (81%) vs. the gentamicin-only group (69%), according to Frada. – by Casey Tingle
Reference:
Frada T, et al. Paper #1456. Presented at: 16th EFORT Congress; May 27-29, 2015; Prague.
Disclosure: Frada reports no relevant financial disclosures.