Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir

Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir

Despite available guidelines on antibiotic prophylaxis for arthroplasty, there is currently no universally defined guideline on the best pharmacological agent for prosthetic joint infection treatment. This research was conducted to investigate the prophylactic antibiotics used in arthroplasty; to as...

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Main Author: Md Tahir, Siti Hir Huraizah
Format: Thesis
Language:English
Published: 2023
Online Access:https://ir.uitm.edu.my/id/eprint/88655/1/88655.pdf
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spelling my-uitm-ir.886552023-12-27T03:35:18Z Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir 2023 Md Tahir, Siti Hir Huraizah Despite available guidelines on antibiotic prophylaxis for arthroplasty, there is currently no universally defined guideline on the best pharmacological agent for prosthetic joint infection treatment. This research was conducted to investigate the prophylactic antibiotics used in arthroplasty; to assess the clinical practice of antibiotic-loaded bone cement among healthcare practitioners and compare the strength and formulation of vancomycin-loaded bone cement in terms of elution properties and antibacterial activity. A retrospective cross-sectional study in patients who underwent arthroplasty from 2008 until 2015. Only 930 records out of 1,122 were retrieved. Almost all patients (94.6%) received IV ceftriaxone given as 1g or 2g as prophylactic antibiotic. A total of 873 patients (93.9%) were also given IV amoxicillin/clavulanic acid 1.2 g as antibiotic irrigation at the wound site after the implant insertion before wound closing. The practice of antibiotic-loaded bone cement was investigated among the orthopaedic surgeons, medical officers, house officers in five tertiary government hospitals. The practice of antibiotic-loaded bone cement was investigated among the orthopaedic surgeons, medical officers, house officers in five tertiary government hospitals. There were statistically significant findings between the designation and working experience versus knowledge and experience handling ALBC. The antibacterial ability and elution properties were also compared among the different preparation and concentration of vancomycin-loaded bone cement against the methicillin-resistant Staphylococcus aureus (MRSA) using disc diffusion method and high-performance liquid chromatography (HPLC). No differences were observed in the zone of inhibition between the amount of vancomycin and in the preparation of bone cement itself (p>0.05). The addition of vancomycin powder before or after the addition of monomer showed no difference in terms of antibacterial activity (p>0.05). The elution of vancomycin showed a burst during the first hour on the first day that for a few days and reached plateau after 72 hours. As conclusion, overall guideline adherence rate was 5.4% only. The practice of ALBC among orthopaedic surgeons differ in terms of antibiotic choices and doses used. Dose of 2 g vancomycin can be manually added into the bone cement to achieve antibacterial activity and eluted concentration needed in treating methicillin-resistant Staphylococcus aureus (MRSA) infection. 2023 Thesis https://ir.uitm.edu.my/id/eprint/88655/ https://ir.uitm.edu.my/id/eprint/88655/1/88655.pdf text en public phd doctoral Universiti Teknologi MARA (UiTM) Faculty of Pharmacy Ariffin, Siti Alwani
institution Universiti Teknologi MARA
collection UiTM Institutional Repository
language English
advisor Ariffin, Siti Alwani
description Despite available guidelines on antibiotic prophylaxis for arthroplasty, there is currently no universally defined guideline on the best pharmacological agent for prosthetic joint infection treatment. This research was conducted to investigate the prophylactic antibiotics used in arthroplasty; to assess the clinical practice of antibiotic-loaded bone cement among healthcare practitioners and compare the strength and formulation of vancomycin-loaded bone cement in terms of elution properties and antibacterial activity. A retrospective cross-sectional study in patients who underwent arthroplasty from 2008 until 2015. Only 930 records out of 1,122 were retrieved. Almost all patients (94.6%) received IV ceftriaxone given as 1g or 2g as prophylactic antibiotic. A total of 873 patients (93.9%) were also given IV amoxicillin/clavulanic acid 1.2 g as antibiotic irrigation at the wound site after the implant insertion before wound closing. The practice of antibiotic-loaded bone cement was investigated among the orthopaedic surgeons, medical officers, house officers in five tertiary government hospitals. The practice of antibiotic-loaded bone cement was investigated among the orthopaedic surgeons, medical officers, house officers in five tertiary government hospitals. There were statistically significant findings between the designation and working experience versus knowledge and experience handling ALBC. The antibacterial ability and elution properties were also compared among the different preparation and concentration of vancomycin-loaded bone cement against the methicillin-resistant Staphylococcus aureus (MRSA) using disc diffusion method and high-performance liquid chromatography (HPLC). No differences were observed in the zone of inhibition between the amount of vancomycin and in the preparation of bone cement itself (p>0.05). The addition of vancomycin powder before or after the addition of monomer showed no difference in terms of antibacterial activity (p>0.05). The elution of vancomycin showed a burst during the first hour on the first day that for a few days and reached plateau after 72 hours. As conclusion, overall guideline adherence rate was 5.4% only. The practice of ALBC among orthopaedic surgeons differ in terms of antibiotic choices and doses used. Dose of 2 g vancomycin can be manually added into the bone cement to achieve antibacterial activity and eluted concentration needed in treating methicillin-resistant Staphylococcus aureus (MRSA) infection.
format Thesis
qualification_name Doctor of Philosophy (PhD.)
qualification_level Doctorate
author Md Tahir, Siti Hir Huraizah
spellingShingle Md Tahir, Siti Hir Huraizah
Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir
author_facet Md Tahir, Siti Hir Huraizah
author_sort Md Tahir, Siti Hir Huraizah
title Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir
title_short Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir
title_full Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir
title_fullStr Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir
title_full_unstemmed Vancomycin-loaded bone cement used in arthroplasty in five Malaysian government hospitals / Siti Hir Huraizah Md Tahir
title_sort vancomycin-loaded bone cement used in arthroplasty in five malaysian government hospitals / siti hir huraizah md tahir
granting_institution Universiti Teknologi MARA (UiTM)
granting_department Faculty of Pharmacy
publishDate 2023
url https://ir.uitm.edu.my/id/eprint/88655/1/88655.pdf
_version_ 1794192138537271296

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