Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics15010.21823/2311-2905-2015-0-3-92-107ReviewsОбзорыReviewsCurrent trends in local antibacterial therapy of periprosthetic infection and osteomyelitisСовременные возможности локальной антибиотикотерапии перипротезной инфекции и остеомиелита (обзор литературы)BozhkovaS. A.БожковаС. А.
Russian Federation
NovokshonovaA. A.НовокшоноваА. А.
Russian Federation
KonevV. A.КоневВ. А.
Russian Federation
Vreden Russian Research Institute of Traumatology and OrthopedicsФГБУ «Российский научно-исследовательский институт травматологии и ортопедии им. Р.Р. Вредена» Минздрава России1210201521392107120920162015https://journal.rniito.org/jour/article/view/150

The rational use of antibiotics in the treatment of orthopedic infection still presents a significant problem. Local antibiotic delivery systems enable to achieve effective concentrations of drugs in the focus of bone infection without the development of toxicity. It is the important accompaniment to systemic antibiotics in the treatment of periprosthetic infection and osteomyelitis. The data collected through the PubMed and eLIBRARY databases (http://www.ncbi.nlm. nih.gov/pubmed, 1995-2015; http://elibrary.ru, 2005-2015 years) present the information about bone substitutes used for local antibiotic therapy in scientific investigations and in clinical practice. The information is submitted in accordance with the groups of materials: cements based on polymethylmethacrylate, bone grafts, demineralized bone matrix, bioceramics, natural and synthetic polymers, combined antibiotic delivery systems. The majority of these materials have only been studied experimentally and only a limited range of them is registered for use in clinical practice. Informing orthopedic surgeons about current methods of local antibiotic use is the key to the development of a modern integrated approach to the therapy of infectious complications after orthopedic surgery.

Вопросы рационального применения антибактериальных препаратов при лечении инфекции костей и суставов до настоящего времени не имеют окончательных ответов. Локальная доставка антибиотиков в очаг инфекции костей и суставов позволяет добиться эффективных концентраций препаратов без развития токсического действия и является важным дополнением к системной антибиотикотерапии. В результате поиска в системах PubMed (1995-2015 гг.) и eLIBRARY (2005-2015 гг.) собраны данные об остеозамещающих материалах, используемых для локальной антибиотикотерапии перипротезной инфекции и остеомиелита в условиях эксперимента и в клинической практике. Данные научных исследований приведены в соответствии с группами материалов: цементы на основе полиметилметакрилата, костные трансплантаты, деминерализованный костный матрикс, биокерамика, природные и синтетические полимеры, комбинированные транспортные системы для антибиотиков. До настоящего времени большинство указанных веществ изучены только в эксперименте, и лишь ограниченный перечень материалов зарегистрирован для применения в клинической практике. Информированность практикующих врачей о существующих методах местной антибактериальной терапии является залогом развития современного комплексного подхода к терапии инфекционных осложнений после ортопедических операций.

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