Keim-orientierte Antibiotikatherapie bei Protheseninfektionen

  • C. Hendrich
  • L. Frommelt


Die Infektion ist die schwer wiegendste Komplikationen moderner Endoprothesen. Hinsichtlich der operativen Interventionsmöglichkeiten und der Antibiotikatherapie hat der Chirurg ohnehin nur eingeschränkte Optionen, so dass einer zielgerichteten Therapie entscheidende Bedeutung zukommt. Eine inkonsequente chirurgische Sanierung wird ebenso wie eine ungeeignete Antibiotikatherapie die weiteren Erfolgsaussichten verschlechtern.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Allerberger F, Klare I (2000) In-vitro activity of fosfomycin against vancomycin-resistant enterococci. J Antimicrob Chemother 43: 211–217CrossRefGoogle Scholar
  2. 2.
    Barlow GD, Nathwani D (2000) Sequential antibiotic therapy. Curr Opin Infect Dis 13: 599–607PubMedCrossRefGoogle Scholar
  3. 3.
    Bassetti M, Di Biagio A, Cenderello G, Del B, V, Palermo A, Cruciani M, Bassetti D (2001) Linezolid treatment of prosthetic hip Infections due to methicillin-resistant Staphylococcus aureus (MRSA). J Infect 43: 148–149PubMedCrossRefGoogle Scholar
  4. 4.
    Bengston S, Knutson K, Lidgren L (1989) Treatment of infected knee arthroplasty. Clin Orthop 245: 173–178PubMedGoogle Scholar
  5. 5.
    Brause BD (1995) Infections with prostheses in bones and joints. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, 4th edn. Churchill Livingstone, New York, pp 1051–1055Google Scholar
  6. 6.
    Buchholz HW, Elson RA, Heinert K (1984) Antibiotic-loaded acrylic cement: current concepts. Clin Orthop 190: 96–108PubMedGoogle Scholar
  7. 7.
    Entenza JM, Que YA, Vouillamoz J, Glauser MP, Moreillon P (2001) Efficacies of moxifloxacin, ciprofloxacin, and vancomycin against experimental endocarditis due to methicillin-resistant Staphylococcus aureus expressing various degrees of ciprofloxacin resistance. Antimicrob Agents Chemother 45: 3076–3083PubMedCrossRefGoogle Scholar
  8. 8.
    Frommelt L, Gehrke T (2000) Das infizierte Kunstgelenk - Mikrobiologische Konzepte. Praxis der Knieendoprothetik. Springer, Berlin Heidelberg New York, Tokyo, S 273–283Google Scholar
  9. 9.
    Garvin KL, Hinrichs SH, Urban JA (1999) Emerging antibiotic-resistant bacteria. Their treatment in total joint arthroplasty. Clin Orthop 369:110–123PubMedCrossRefGoogle Scholar
  10. 10.
    Graham JC, Gould FK (2002) Role of aminoglycosides in the treatment of bacterial endocarditis. J Antimicrob Chemother 49: 437–444PubMedCrossRefGoogle Scholar
  11. 11.
    Gristina AG, Costerton JW (1985) Bacterial adherence to biomaterials and tissue. The significance of its role in clinical sepsis. J Bone Joint Surg Am 67: 264–273PubMedGoogle Scholar
  12. 12.
    Holtom PD, Zamorano D, Patzakis MJ (2002) Osteomyelitis attributable to vancomycin-resistant enterococci. Clin Orthop 403: 38–44PubMedCrossRefGoogle Scholar
  13. 13.
    Kühn K-D (2001) Wirkstoff-Freisetzung. Knochenzemente für die Endoprothetik. Springer, Berlin Heidelberg New York, Tokyo, S 268–274CrossRefGoogle Scholar
  14. 14.
    LeFrock JL, Ristuccia AM, Ristuccia PA et al. (1992) Teicoplanin in the treatment of bone and joint infections. Teicoplanin Bone and Joint Cooperative Study Group, USA. Eur J Surg [Suppl]: 9–13Google Scholar
  15. 15.
    Mader JT, Calhoun J (1995) Osteomyelitis. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, 4th edn. Churchill Livingstone, New York, pp 1039–1051Google Scholar
  16. 16.
    Masri BA, Duncan CP, Beauchamp CP (1998) Long-term elution of antibiotics from bone-cement: an in vivo study using the prosthesis of antibiotic-loaded acrylic cement (PROSTA - LAC) system. J Arthroplasty 13: 331–338PubMedCrossRefGoogle Scholar
  17. 17.
    Meissner A, Haag R, Rahmanzadeh R (1989) Adjuvant fosfomycin medication in chronic osteomyelitis. Infection 17: 146–151PubMedCrossRefGoogle Scholar
  18. 18.
    Nelson CL, Evans RP, Blaha JD, Calhoun J, Henry SL, Patzakis MJ (1993) A comparison of gentamicin-impregnated polymethylmethacrylate bead implantation to conventional parenteral antibiotic therapy in infected total hip and knee arthroplasty. Clin Orthop 295: 96–101PubMedGoogle Scholar
  19. 19.
    Nichols RL, Graham DR, Barriere SL, Rodgers A, Wilson SE, Zervos M, Dunn DL, Kreter B Treatment of hospitalized patients with complicated gram-positive skin and skin structure infections: two randomized, multicentre studies of quinupristin/dalfopristin versus cefazolin, oxacillin or vancomycin. Synercid Skin and Skin Structure Infection Group. J Antimicrob Chemother 44: 263–273PubMedCrossRefGoogle Scholar
  20. 20.
    Nichols RL, Smith JW, Geckler RW, Wilson SE (1995) Meropenem versus imipenem/cilastatin in the treatment of hospitalized patients with skin and soft tissue infections. South Med J 88: 397–404PubMedCrossRefGoogle Scholar
  21. 21.
    Olaison L, Schadewitz K (2002) Enterococcal endocarditis in Sweden, 1995–1999: can shorter therapy with aminoglycosides be used? Clin Infect Dis 34: 159–166PubMedCrossRefGoogle Scholar
  22. 22.
    Rao N, Crossett LS, Sinha RK, Le Frock JL (2003) Long-term suppression of infection in total joint arthroplasty. Clin Orthop 414: 55–60PubMedCrossRefGoogle Scholar
  23. 23.
    Ravindran V, John J, Kaye GC, Meigh RE (2003) Successful use of oral linezolid as a single active agent in endocarditis unresponsive to conventional antibiotic therapy. J Infect 47: 164–166PubMedCrossRefGoogle Scholar
  24. 24.
    Salvati EA (1994) Diagnosis and management of the infected hip. Orthopedics 17: 811–814PubMedGoogle Scholar
  25. 25.
    Sano T, Sakurai M, Dohi S et al. (1993) Investigation of meropenem levels in the human bone marrow blood, bone, joint fluid and joint tissues. Jpn J Antibiot 46: 159–163PubMedGoogle Scholar
  26. 26.
    Schafroth M, Zimmerli W, Ochsner PE (1999) The infected artificial hip joint: possibilities, follow-up and results of treatment. Schweiz Rundsch Med Prax 88: 2101–2105Google Scholar
  27. 27.
    Schoifet SD, Morrey BF (1990) Treatment of infection after total knee arthroplasty by débridement with retention of the components. J Bone Joint Surg Am 72: 1383–1390PubMedGoogle Scholar
  28. 28.
    Stevens DL, Smith LG, Bruss JB, McConnell-Martin MA, Duvall SE, Todd WM, Hafkin B Randomized comparison of linezolid (PNU-100766) versus oxacillin-dicloxacillin for treatment of complicated skin and soft tissue infections. Antimicrob Agents Chemother 44: 3408–3413PubMedCrossRefGoogle Scholar
  29. 29.
    Tattevin P, Cremieux AC, Pottier P, Huten D, Carbon C (1999) Prosthetic joint infection: when can prosthesis salvage be considered? Clin Infect Dis 29: 292–295PubMedCrossRefGoogle Scholar
  30. 30.
    Tsukayama DT, Wicklund B, Gustilo RB (1991) Suppressive antibiotic therapy in chronic prosthetic joint infections. Orthopedics 14: 841–844PubMedGoogle Scholar
  31. 31.
    Wilson WR, Karchmer AW, Dajani AS et al. (1995) Antibiotic treatment of adults with infective endocarditis due to streptococci, enterococci, staphylococci, and HACEK microorganisms. American Heart Association. JAMA 274: 1706–1713PubMedCrossRefGoogle Scholar
  32. 32.
    Zimmerli W (1995) Role of antibiotics in the treatment of infected joint prosthesis. Orthopäde 24:308–313PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • C. Hendrich
  • L. Frommelt

There are no affiliations available

Personalised recommendations