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Prosthesis infections are difficult to cure. Infection with methicillin-resistant staphylococci is becoming more common in patients with orthopedic implants. Using a recently developed model of methicillin-resistant Staphylococcus aureus MRSA infection of a knee prosthesis, we compared the efficacies of teicoplanin and vancomycin. A partial knee replacement was performed with a silicone implant fitting into the intramedullary canal of the tibia, and 10 7 CFU of MRSA was injected into the knee.
Mean peak and trough levels in serum were Fifteen days after the end of therapy, the animals were killed and their tibias were removed, pulverized, and quantitatively cultured.
The bacterial covents of teicoplanin- and vancomycin-treated rabbits were comparable. The [ 14 C]teicoplanin autoradiographic diffusion patterns in rabbits with prostheses, two of which were uninfected and two of which were infected, were studied 15 days after inoculation. Radioactivity was less intense in epiphyseal disk cartilage, femoral cartilage, articular ligaments, and muscles and was weak in compact bone.
A similar distribution pattern was seen in uninfected rabbits. Thus, teicoplanin may represent an effective alternative therapy for the treatment of these infections. Prosthetic joint infection is a severe complication of total joint arthroplasty. Perioperative contamination is responsible for most infections, which are mainly due to Staphylococcus aureus or Staphylococcus epidermidis Surgical debridement, removal of all foreign material, and prolonged high-dose intravenous i.