Topical rifampin powder for orthopedic trauma part I: Rifampin powder reduces recalcitrant infection in a delayed treatment musculoskeletal trauma model

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
Stefanie M ShielsJoseph C Wenke

Abstract

Open fractures become infected despite meticulous debridement and care. Locally applied antibiotics, commonly embedded in polymethylmethacrylate, deliver high doses of drug directly to the fracture site. Direct application of antibiotic powder, which is being applied prophylactically in spine surgery, is a recent interest in the trauma sector, where bacterial biofilms are more prevalent. Traditional antibiotics, such as vancomycin, are poor performers against bacterial biofilms thus are ineffective in delayed treatment. Rifampin is an effective eradicator of Staphylococcal biofilms. Here, a rat model of musculoskeletal trauma was used to evaluate the utility of locally applied rifampin powder for reducing established orthopedic Staphylococcal infections in a delayed treatment scenario that previously indicated the limited use of local vancomycin. By applying rifampin powder directly to the contaminated segmental defect, the number of bacteria, as well as clinical indications of infection, were significantly reduced compared to vancomycin and daptomycin. Considering the Infectious Disease Society of America's recommendation to use rifampin in combination with another antibiotic to reduce the onset of rifampin resistance, rifampi...Continue Reading

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Citations

Oct 3, 2018·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Stefanie M ShielsJoseph C Wenke
May 1, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Yang XieWen Xie
Jul 23, 2019·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Michiel CroesH Charles Vogely
Aug 30, 2019·Journal of Orthopaedic Trauma·Willem-Jan MetsemakersUNKNOWN Fracture-Related Infection (FRI) consensus group
Jan 5, 2021·The Journal of Bone and Joint Surgery. American Volume·UNKNOWN Machine Learning Consortium, on behalf of the SPRINT and FLOW Investigators
Oct 31, 2020·BioMed Research International·Jan Miroslav HartingerTomáš Grus

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