RESUMO
Antibiotic-loaded bone cement is extensively used in joint arthroplasty, but increasing bacteria resistance against common antibiotics has lead to a demand for alternative drugs. However, bone cement containing new additives must be characterized both biologically and mechanically. This study evaluated elution kinetics, antibacterial activity, and mechanical properties for cement loaded with vancomycin and/or meropenem. The presence of meropenem broadened the antibacterial spectrum and enhanced the elution of vancomycin. The mechanical properties were negatively affected by 1.0 g of vancomycin, but these detrimental effects were acceptable when only 0.5 g of vancomycin were added to a cement containing 0.5 g of meropenem. Further investigations on this formulation with adjusted antibiotic amounts are, however, necessary to reach the optimal compromise between the antibacterial and the mechanical properties of the bone cement.
Assuntos
Antibacterianos/farmacologia , Polimetil Metacrilato , Tienamicinas/administração & dosagem , Tienamicinas/farmacologia , Vancomicina/administração & dosagem , Vancomicina/farmacologia , Antibacterianos/administração & dosagem , Fenômenos Biomecânicos , Química Farmacêutica , Sistemas de Liberação de Medicamentos , Enterococcus/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Humanos , Meropeném , Infecções Relacionadas à Prótese/tratamento farmacológico , Pseudomonas/efeitos dos fármacos , Staphylococcus/efeitos dos fármacosRESUMO
UNLABELLED: What impact does day surgery have on primary treatment? AIMS: highlighting the impact that day surgery has on the system of primary treatment. RESULTS: The study highlighted a lack in continuity of treatment due to a breakdown in communication between hospital specialists and general practitioners. This reflects the growing habit in the medical field whereby hospital surgeons take charge of surgical indications and carrying out the operation, thus focusing their attention on their own limited scope of action. On the other hand general practitioners are called upon merely to hand out prescriptions and certificates. However, it seems obvious that general practitioners should be involved in the selection phase and discharge of the patient, as occurs in countries where one-day surgery is now in widespread use. That is the only way to improve the quality of healthcare assistance and contain costs to the national health service.