Articles | Volume 6, issue 5
https://doi.org/10.5194/jbji-6-147-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-6-147-2021
© Author(s) 2021. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Safety and tolerability of liquid amikacin in antibiotic-loaded bone cement – a case series
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
Nathan J. Brinkman
Department of Pharmacy, Mayo Clinic, Rochester, MN 55905, USA
Omar Abu Saleh
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
Douglas R. Osmon
Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
Matthew P. Abdel
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905,
USA
Christina G. Rivera
Department of Pharmacy, Mayo Clinic, Rochester, MN 55905, USA
Related authors
Nicolás Cortés-Penfield, Don Bambino Geno Tai, and Angela Hewlett
J. Bone Joint Infect., 9, 161–165, https://doi.org/10.5194/jbji-9-161-2024, https://doi.org/10.5194/jbji-9-161-2024, 2024
Short summary
Short summary
This survey study describes the composition of US-based orthopedic infectious diseases (Ortho ID) teams across more than a dozen large academic medical centers, finding many institutions have dedicated Ortho ID clinics or inpatient services. These teams are highly valued by both ID clinicians and surgeons for engendering strong multidisciplinary relationships and improving patient outcomes.
Pansachee Damronglerd, Eibhlin Higgins, Madiha Fida, Don Bambino Geno Tai, Aaron J. Tande, Matthew P. Abdel, and Omar M. Abu Saleh
J. Bone Joint Infect., 9, 99–106, https://doi.org/10.5194/jbji-9-99-2024, https://doi.org/10.5194/jbji-9-99-2024, 2024
Short summary
Short summary
This work investigates periprosthetic joint infection (PJI) caused by rapidly growing mycobacteria (RGM) following total joint arthroplasty. Eight patients were identified as part of a retrospective review. The isolated RGM species included Mycobacterium abscessus (three cases), M. fortuitum (three cases), and one case each of M. immunogenum and M. mageritense. We provide novel insights into the successful treatment of PJIs caused by newly identified RGM (M. immunogenum and M. mageritense).
Matteo Passerini, Julian Maamari, Don Bambino Geno Tai, Robin Patel, Aaron J. Tande, Zelalem Temesgen, and Elie F. Berbari
J. Bone Joint Infect., 8, 143–149, https://doi.org/10.5194/jbji-8-143-2023, https://doi.org/10.5194/jbji-8-143-2023, 2023
Short summary
Short summary
Physicians have difficulties interpreting the isolation of Cutibacterium acnes in the spine tissue. Here we provide the experience of our center about this topic, adding data that can help physicians in their choices. Our results show that some clinical, radiological, and microbiological features can help distinguish patients to treat or not to treat. Moreover, treatment with parenteral beta-lactams appears to be effective, but targeted oral therapy could be a valid alternative.
Eibhlin Higgins, Don Bambino Geno Tai, Brian Lahr, Gina A. Suh, Elie F. Berbari, Kevin I. Perry, Matthew P. Abdel, and Aaron J. Tande
J. Bone Joint Infect., 8, 125–131, https://doi.org/10.5194/jbji-8-125-2023, https://doi.org/10.5194/jbji-8-125-2023, 2023
Short summary
Short summary
This retrospective case-matched study evaluated males and females with staphylococcal PJI (periprosthetic joint infection) treated with two-stage exchange arthroplasty. We matched 156 males and females for age, type of staphylococcal infection, and joint involved. We compared clinical parameters related to presentation, treatment, and outcome. We did not find a statistically significant difference in outcome between males and females treated with the same surgical approach at our institution.
Kareme D. Alder, Anthony P. Fiegen, Matthew M. Rode, Don Bambino Geno Tai, Gina A. Suh, Abinash Virk, and Nicholas Pulos
J. Bone Joint Infect., 8, 39–44, https://doi.org/10.5194/jbji-8-39-2023, https://doi.org/10.5194/jbji-8-39-2023, 2023
Short summary
Short summary
We present the first published case of bilateral extensor tenosynovitis caused by Coxiella burnetii. C. burnetii should be considered in patients with inflammatory osteoarticular disease, including tenosynovitis, when conventional cultures are negative especially in elderly, male, or immunocompromised patients with exposure to animals.
Julian Maamari, Aaron J. Tande, Felix Diehn, Don Bambino Geno Tai, and Elie F. Berbari
J. Bone Joint Infect., 7, 23–32, https://doi.org/10.5194/jbji-7-23-2022, https://doi.org/10.5194/jbji-7-23-2022, 2022
Short summary
Short summary
The yearly incidence of native vertebral osteomyelitis (NVO) is increasing. In 2013 the prevalence of NVO in the USA was 5.4 cases per 100 000. Delays in the diagnosis of NVO remain common, in part due to the insidious nature of the infection and its related symptoms. The mean time between the onset of symptoms to diagnosis of NVO is 45.5 d. We herein review available and novel diagnostic modalities at the disposal of healthcare providers to reach an accurate and timely diagnosis of NVO.
Ryan B. Khodadadi, Jack W. McHugh, Supavit Chesdachai, Nancy L. Wengenack, Wendelyn Bosch, Maria Teresa Seville, Douglas R. Osmon, Elena Beam, and Zachary A. Yetmar
J. Bone Joint Infect., 9, 207–212, https://doi.org/10.5194/jbji-9-207-2024, https://doi.org/10.5194/jbji-9-207-2024, 2024
Short summary
Short summary
In a multicenter retrospective study of musculoskeletal Nocardia infections (2011–2022), nine cases were identified. Disseminated disease occurred in 33 %, all in solid organ transplant recipients. Surgical intervention was common (89 %), with varied treatment duration (21–467 d). The 1-year mortality was 22%; all fatal cases involved disseminated disease. Localized infection generally had favorable outcomes compared to disseminated disease and requires a collaborative approach for management.
Nicolás Cortés-Penfield, Don Bambino Geno Tai, and Angela Hewlett
J. Bone Joint Infect., 9, 161–165, https://doi.org/10.5194/jbji-9-161-2024, https://doi.org/10.5194/jbji-9-161-2024, 2024
Short summary
Short summary
This survey study describes the composition of US-based orthopedic infectious diseases (Ortho ID) teams across more than a dozen large academic medical centers, finding many institutions have dedicated Ortho ID clinics or inpatient services. These teams are highly valued by both ID clinicians and surgeons for engendering strong multidisciplinary relationships and improving patient outcomes.
Pansachee Damronglerd, Eibhlin Higgins, Madiha Fida, Don Bambino Geno Tai, Aaron J. Tande, Matthew P. Abdel, and Omar M. Abu Saleh
J. Bone Joint Infect., 9, 99–106, https://doi.org/10.5194/jbji-9-99-2024, https://doi.org/10.5194/jbji-9-99-2024, 2024
Short summary
Short summary
This work investigates periprosthetic joint infection (PJI) caused by rapidly growing mycobacteria (RGM) following total joint arthroplasty. Eight patients were identified as part of a retrospective review. The isolated RGM species included Mycobacterium abscessus (three cases), M. fortuitum (three cases), and one case each of M. immunogenum and M. mageritense. We provide novel insights into the successful treatment of PJIs caused by newly identified RGM (M. immunogenum and M. mageritense).
Matteo Passerini, Julian Maamari, Don Bambino Geno Tai, Robin Patel, Aaron J. Tande, Zelalem Temesgen, and Elie F. Berbari
J. Bone Joint Infect., 8, 143–149, https://doi.org/10.5194/jbji-8-143-2023, https://doi.org/10.5194/jbji-8-143-2023, 2023
Short summary
Short summary
Physicians have difficulties interpreting the isolation of Cutibacterium acnes in the spine tissue. Here we provide the experience of our center about this topic, adding data that can help physicians in their choices. Our results show that some clinical, radiological, and microbiological features can help distinguish patients to treat or not to treat. Moreover, treatment with parenteral beta-lactams appears to be effective, but targeted oral therapy could be a valid alternative.
Eibhlin Higgins, Don Bambino Geno Tai, Brian Lahr, Gina A. Suh, Elie F. Berbari, Kevin I. Perry, Matthew P. Abdel, and Aaron J. Tande
J. Bone Joint Infect., 8, 125–131, https://doi.org/10.5194/jbji-8-125-2023, https://doi.org/10.5194/jbji-8-125-2023, 2023
Short summary
Short summary
This retrospective case-matched study evaluated males and females with staphylococcal PJI (periprosthetic joint infection) treated with two-stage exchange arthroplasty. We matched 156 males and females for age, type of staphylococcal infection, and joint involved. We compared clinical parameters related to presentation, treatment, and outcome. We did not find a statistically significant difference in outcome between males and females treated with the same surgical approach at our institution.
Christin A. Tiegs-Heiden, Tanner C. Anderson, Mark S. Collins, Matthew P. Johnson, Douglas R. Osmon, and Doris E. Wenger
J. Bone Joint Infect., 8, 99–107, https://doi.org/10.5194/jbji-8-99-2023, https://doi.org/10.5194/jbji-8-99-2023, 2023
Short summary
Short summary
Magnetic resonance imaging (MRI) is an imaging test that is often used in patients with a suspected bone infection in their foot. MRI findings may impact how these patients are treated; thus, it is important to understand the significance of various MRI findings. This study compared different patterns of MRI findings in these patients to their clinical outcomes. Patients with classic features of bone infection on MRI had the worst outcomes, whereas patients without them sometimes healed.
Kareme D. Alder, Anthony P. Fiegen, Matthew M. Rode, Don Bambino Geno Tai, Gina A. Suh, Abinash Virk, and Nicholas Pulos
J. Bone Joint Infect., 8, 39–44, https://doi.org/10.5194/jbji-8-39-2023, https://doi.org/10.5194/jbji-8-39-2023, 2023
Short summary
Short summary
We present the first published case of bilateral extensor tenosynovitis caused by Coxiella burnetii. C. burnetii should be considered in patients with inflammatory osteoarticular disease, including tenosynovitis, when conventional cultures are negative especially in elderly, male, or immunocompromised patients with exposure to animals.
Julian Maamari, Aaron J. Tande, Felix Diehn, Don Bambino Geno Tai, and Elie F. Berbari
J. Bone Joint Infect., 7, 23–32, https://doi.org/10.5194/jbji-7-23-2022, https://doi.org/10.5194/jbji-7-23-2022, 2022
Short summary
Short summary
The yearly incidence of native vertebral osteomyelitis (NVO) is increasing. In 2013 the prevalence of NVO in the USA was 5.4 cases per 100 000. Delays in the diagnosis of NVO remain common, in part due to the insidious nature of the infection and its related symptoms. The mean time between the onset of symptoms to diagnosis of NVO is 45.5 d. We herein review available and novel diagnostic modalities at the disposal of healthcare providers to reach an accurate and timely diagnosis of NVO.
Holly Duck, Suzanne Tanner, Debra Zillmer, Douglas Osmon, and Kevin Perry
J. Bone Joint Infect., 6, 393–403, https://doi.org/10.5194/jbji-6-393-2021, https://doi.org/10.5194/jbji-6-393-2021, 2021
Short summary
Short summary
This paper describes an ultrasound guided technique for aspiration of hip arthroplasties that has not been published. We believe this technique is important because it yields useful fluid 99 % of the time with low contamination rate (2 %). Ultrasound, although common in Europe, is gaining popularity in the United States. Besides teaching a useful technique, this paper also discusses findings of lavage-obtained samples which are rarely discussed in other aspiration papers.
Talha Riaz, Mark Collins, Mark Enzler, Marco Rizzo, Audrey N. Schuetz, Julia S. Lehman, Douglas Osmon, and Irene G. Sia
J. Bone Joint Infect., 6, 355–361, https://doi.org/10.5194/jbji-6-355-2021, https://doi.org/10.5194/jbji-6-355-2021, 2021
Short summary
Short summary
Tenosynovitis due to Histoplasma capsulatum in an immunocompromised host warrants special attention. Following surgical debridement, the patient initially improved on antifungal therapy, but as immunosuppression was decreased, she presented with a flare, requiring further debridement. With negative fungal cultures and declining antigenemia, it was felt that her interim worsening was as a consequence of immune reconstitution inflammatory syndrome (IRIS).
Related subject area
Subject: Anti-bacterial agents | Topic: Local administration
Local delivery of linezolid in the treatment of complex orthopedic bone and joint infections in patients with vancomycin allergy: a case series
The efficacy of antibiotic-impregnated calcium sulfate (AICS) in the treatment of infected non-union and fracture-related infection: a systematic review
Simulated large joint fluid model for evaluating intra-articular antibiotic delivery systems: initial evaluation using antibiotic-loaded calcium sulfate beads
Pursuit of the ideal antiseptic irrigation solution in the management of periprosthetic joint infections
Abhijith Annasamudram, Aja Janyavula, Ahmed H. Elhessy, Raj Krishna Shrestha, Martin Gesheff, and Janet D. Conway
J. Bone Joint Infect., 9, 121–126, https://doi.org/10.5194/jbji-9-121-2024, https://doi.org/10.5194/jbji-9-121-2024, 2024
Short summary
Short summary
A retrospective study on 13 patients treated with linezolid-loaded spacers for bone and joint infections revealed that 9 patients achieved successful limb salvage and remained infection-free after an average follow-up of 55.5 months. Linezolid-loaded bone cement is a viable option for managing chronic bone and joint infections, especially in patients with vancomycin allergy.
Connor C. Jacob, Jad H. Daw, and Juan Santiago-Torres
J. Bone Joint Infect., 8, 91–97, https://doi.org/10.5194/jbji-8-91-2023, https://doi.org/10.5194/jbji-8-91-2023, 2023
Short summary
Short summary
Sometimes after surgery to repair an injured bone or joint, infection can cause the bone to heal improperly. Surgeons use calcium sulfate to prevent infections in joints after surgery. Calcium sulfate can be impregnated with antibiotics and placed inside the joint, where the bloodstream often cannot deliver intravenous or oral antibiotics effectively. We reviewed 20 years of studies of the effectiveness of calcium sulfate and found high rates of healing and infection eradication.
Edward J. McPherson, Jessica A. Jennings, Omar Yunis, Michael A. Harris, Matthew V. Dipane, Nora L. Curtin, Madhav Chowdhry, Andrew J. Wassef, Joel D. Bumgardner, and Scott P. Noel
J. Bone Joint Infect., 7, 117–125, https://doi.org/10.5194/jbji-7-117-2022, https://doi.org/10.5194/jbji-7-117-2022, 2022
Short summary
Short summary
A simulated large joint model has been established to help better understand the elution mechanics of antimicrobial agents and the devices used to deliver them to a large human joint. This model is unique to previously published models in that it more accurately represents the environment of a large human joint. The model was employed to evaluate four brands of commercial medical-grade calcium sulfate. These products were evaluated in both an unaltered state and when mixed with antibiotics.
Ahmed Siddiqi, Zuhdi E. Abdo, Bryan D. Springer, and Antonia F. Chen
J. Bone Joint Infect., 6, 189–198, https://doi.org/10.5194/jbji-6-189-2021, https://doi.org/10.5194/jbji-6-189-2021, 2021
Short summary
Short summary
Irrigation and debridement in the treatment of periprosthetic joint infection (PJI) serves an integral role in the eradication of bacterial burden and subsequent re-infection rates. Identifying the optimal irrigation agent, however, remains challenging, as there is limited data on superiority. Future clinical studies are needed to identify ideal irrigation solutions with optimal bactericidal properties and low cytotoxicity for PJI treatment.
Cited articles
Anagnostakos, K. and Meyer, C.: Antibiotic Elution from Hip and Knee Acrylic
Bone Cement Spacers: A Systematic Review, BioMed Res. Int.,
2017, 4657874, https://doi.org/10.1155/2017/4657874, 2017.
Athans, V., Veve, M. P., and Davis, S. L.: Trowels and Tribulations: Review
of Antimicrobial-Impregnated Bone Cements in Prosthetic Joint Surgery,
Pharmacotherapy, J. Human Pharmacol. Drug Ther., 37,
1565–1577, https://doi.org/10.1002/phar.2040, 2017.
Chang, Y. H., Tai, C. L., Hsu, H. Y., Hsieh, P. H., Lee, M. S., and Ueng, S.
W.: Liquid antibiotics in bone cement: an effective way to improve the
efficiency of antibiotic release in antibiotic loaded bone cement, Bone
Joint Res., 3, 246–251, https://doi.org/10.1302/2046-3758.38.2000305, 2014.
Ethell, M. T., Bennett, R. A., Brown, M. P., Merritt, K., Davidson, J. S.,
and Tran, T.: In Vitro Elution of Gentamicin, Amikacin, and Ceftiofur From
Polymethylmethacrylate and Hydroxyapatite Cement, Vet. Surg., 29,
375–382, https://doi.org/10.1053/jvet.2000.7535, 2000.
Goldstein, N., St. Clair, J. B., Kasperbauer, S. H., Daley, C. L., and
Lindeque, B.: Nontuberculous Mycobacterial Musculoskeletal Infection Cases
from a Tertiary Referral Center, Colorado, USA, Emerg. Infect. Dis., 25,
1075–1083, https://doi.org/10.3201/eid2406.181041, 2019.
Schwarz, E. M., McLaren, A. C., Sculco, T. P., Brause, B., Bostrom, M.,
Kates, S. L., Parvizi, J., Alt, V., Arnold, W. V., Carli, A., Chen, A. F.,
Choe, H., Coraça-Huber, D. C., Cross, M., Ghert, M., Hickok, N.,
Jennings, J. A., Joshi, M., Metsemakers, W.-J., Ninomiya, M., Nishitani, K.,
Oh, I., Padgett, D., Ricciardi, B., Saeed, K., Sendi, P., Springer, B.,
Stoodley, P., Wenke, J. C., and Hospital for Special Surgery 2019 Biofilm Symposium Workgroup: Adjuvant
antibiotic-loaded bone cement: Concerns with current use and research to
make it work, J. Orth. Res., 39, 227–239,
https://doi.org/10.1002/jor.24616, 2021.
WHO-UMC: The use of the WHO-UMC system for standardised case causality assessment, available at:
https://www.who-umc.org/media/164200/who-umc-causality-assessment_new-logo.pdf, last access: 18 February 2021.
Short summary
Antibiotics are frequently used in bone cement during joint replacements or treatment of bone and joint infections. Amikacin is rarely used in bone cement, particularly the liquid formulation. We describe a series of patients in which liquid amikacin was incorporated into bone cement. We did not observe the occurrence of adverse drug reactions definitively attributed to its use. All patients had favorable outcomes.
Antibiotics are frequently used in bone cement during joint replacements or treatment of bone...