EVALUATION OF BIODEGRADABLE CEFAZOLIN SODIUM MICROSPHERES FOR THE PREVENTION OF INFECTION IN RABBITS WITH EXPERIMENTAL OPEN TIBIAL FRACTURES STABILIZED WITH INTERNAL-FIXATION
E. Jacob et al., EVALUATION OF BIODEGRADABLE CEFAZOLIN SODIUM MICROSPHERES FOR THE PREVENTION OF INFECTION IN RABBITS WITH EXPERIMENTAL OPEN TIBIAL FRACTURES STABILIZED WITH INTERNAL-FIXATION, Journal of orthopaedic research, 11(3), 1993, pp. 404-411
Immediate internal fixation of severe open tibial fractures usually is
contraindicated due to the high risk of infection. The objective of t
his study was to evaluate the efficacy of local antibiotic therapy wit
h biodegradable poly-(DL-lactide-co-glycolide) cefazolin-loaded micros
pheres for the prevention of infection in experimental open fractures
stabilized with internal fixation. Rabbits with experimental tibial fr
actures that were contaminated with Staphylococcus aureus were treated
with local application of cefazolin microspheres, an equivalent local
dose of free Ancef powder, or systemic Ancef therapy. The bones then
were fixed with a four-hole plate, and the animals were observed for 8
weeks. Clinically, deep infection was present in 86% of control anima
ls that received no antibiotics and in 60% of animals that received a
7 day course of systemic Ancef therapy. In contrast, no infections wer
e noted among any of the surviving rabbits that received local therapy
with either cefazolin microspheres or free Ancef powder. Significantl
y higher levels of serum cefazolin were measured at 1 h for animals tr
eated with free Ancef powder (18.7 +/- 6.1 mug/ml) than for those trea
ted with cefazolin microspheres (0.57 +/- 0.27 mug/ml). Follow-up stud
ies are in progress to evaluate further the potential clinical benefit
s of local antibiotic therapy for the management of contaminated open
fractures in humans.