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Volume 22 - Issue 1, January-March 2020
SHORT REPORTS
EXPERIENCE WITH AMPHOTERICIN B DEOXYCHOLATE LOADED BONE CEMENT IN STAGED TREATMENT OF OSTEOARTICULAR INFECTIONS
GÓMEZ GANDA LAURA, CORONA PÉREZ-CARDONA PABLO, GARCÍA ORTEGA PATRICIA, LARROSA GARCÍA MARÍA, AMAT MATEU CARLOS, CARRERA CALDERER LUIS, JUÁREZ GIMÉNEZ JUAN CARLOS


The osteoarticular infections arena can include osteomyelitis, septic arthritis, fracture-related infections and periprostheticjoint infections, the latestone of the most feared postsurgical complication after joint replacement surgery. Fungal infections are much less frequent than bacterial infections; however, they have,
theoretically, a poorer prognosis. The most accepted treatment for any musculoskeletal fungal infection is a staged surgical approach, which implies, apart from surgical debridement the administration of antibiotics and antifungals, bothsystemically and locally thought drug-loaded bone cement used to conform and/or fix bone-cement spacers, bone substitutes or auto/allografts.
Two cases are presented in this paper. The first patient sustaineda chronic osteomyelitis and the second a delayedhip periprostheticjoint infection; the pathogens were a Candida parapsilopsis and Candida albicans respectively. Both patients underwent a surgical procedure using high dosesof local amphotericin B
deoxycholate powder (Amphotericin B for injection USP ®), together with vancomycin and gentamicin during the first step of the procedure; once the infection was considered controlled a secondary reconstructive procedure was performed.
Both patients had an adequate clinical evolution, with neither renal impairment nor other antifungal-related adverse events. To this day, patients have not suffered relapse of the fungal infection.

AMPHOTERICIN B DEOXYCHOLATE – BONE CEMENT – FUNGAL PERIPROSTHETICINFECTION



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