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Delivery of Antifungal Agents from Bone Cement

  • Pharmacology and Pharmacodynamics of Antifungal Agents (P Gubbins, Section Editor)
  • Published:
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Abstract

Fungal osteoarticular infections, including prosthetic joint infections and osteomyelitis, are rare yet present a therapeutic challenge with no guidelines to direct optimal treatment. When these infections occur, the majority are due to Candida species. In addition to systemic therapy, adjunctive antifungal-loaded bone cement has been utilized to successfully treat these infections. Amphotericin B is used most commonly, but cases utilizing voriconazole, fluconazole, and itraconazole have been reported as well. In vitro data suggest better elution of voriconazole from bone cement while there is minimal elution of amphotericin B. Unfortunately, a lack of consistency in the methods of both in vitro studies and case reports makes it difficult to determine if the addition of an antifungal agent in bone cement improves outcomes in fungal osteoarticular infections. This article provides an overview of bone cement as a delivery system for antifungal agents in vitro and in clinical reports.

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Authors and Affiliations

  1. Clinical Sciences Department, Drake University College of Pharmacy and Health Sciences, 2507 University Avenue, Des Moines, IA, 50311, USA

    Kelly M. Percival

  2. Department of Pharmacy and Infection Prevention, Mercy Medical Center, 1111 6th Avenue, Des Moines, IA, 50314, USA

    Jeffery T. Brock

  3. Department of Pharmacy, Mercy Medical Center, 1111 6th Avenue, Des Moines, IA, 50314, USA

    Nathan D. Peterson

Authors
  1. Kelly M. Percival
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  2. Jeffery T. Brock
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  3. Nathan D. Peterson
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Correspondence to Kelly M. Percival.

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The authors declare that they have no competing interests.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Pharmacology and Pharmacodynamics of Antifungal Agents

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Percival, K.M., Brock, J.T. & Peterson, N.D. Delivery of Antifungal Agents from Bone Cement. Curr Fungal Infect Rep 10, 30–36 (2016). https://doi.org/10.1007/s12281-016-0251-8

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  • DOI: https://doi.org/10.1007/s12281-016-0251-8

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