Antibiotics

Abstract

The use of antibiotics in orthopaedic surgery has become popular since the discovery of penicillin during the second world war. All penicillins are bactericidal, ß-lactam class antibiotics and used in the treatment of infections caused by mostly gram-positive and other susceptible bacteria. Especially, methicillin, cephalosporins, vancomycin, teicoplanin, rifampicin, quinolones, aminoglicozides widely used in orthopaedic infection treatment or proflaxy of ortopaedic surgery. In proflaxy of orthopaedic surgery, first-generation cephalosporins have been used since they are effective against S. Aureus and S. Epidermidis, and are cheaper and non-toxic. The aim of the ostemyelitis treatment whether it is curative or supressive, will define the selection of antibiotics, proper dosage, and duration of treatment. In the treatment of bone infections should be coise of antibiotics against target pathogens. Usually, vancomycin and teicoplanin are glycopeptid antibiotics that are widely employed in methicillin-resistant infections. Recently, the use of linezolid, daptomycin or tigecycline is popular in the treatment of methicilline-resistant infections. Rifampin and fluoroquinolones combination are frequently used in the treatment of chronic osteomyelitis. Another problem, unfortunately, enterococcus faecalis quickly develop resistance to vancomycin. Linezolid, tigecycline and daptomycine can be used in this cases.