Bone and Joint Infections: From Microbiology to Diagnostics by W. Zimmerli

By W. Zimmerli

Bone and Joint Infections is the 1st booklet to take a multidisciplinary method of masking the explanations and remedy of osteomyelitis and septic arthritis. right and swift analysis of bone and joint an infection calls for the enter of numerous experts, and Bone and Joint Infection takes a similarly collaborative and comprehensive approach, together with chapters from a diverse workforce of clinicians, researchers, and surgeons.

Covering either the elemental microbiology and medical elements of bone and joint an infection, this publication can be a worthy source either for researchers within the lab and for physicians and surgeons looking a complete reference on osteomyelitis and septic arthritis.

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Extra info for Bone and Joint Infections: From Microbiology to Diagnostics and Treatment

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However, in treating bone infections, adequate antibiotic concentrations need to be achieved at the site of infection in bone. Numerous clinical studies have been conducted to quantify ­antibiotic concentrations in bone. Bone and Joint Infections: From Microbiology to Diagnostics and Treatment, First Edition. Edited by Werner Zimmerli. © 2015 John Wiley & Sons, Inc. Published 2015 by John Wiley & Sons, Inc. 21 22 Bone and Joint Infections Bone is a heterogeneous tissue, where the organic bone matrix represents 30–35% of total bone mass and includes collagen fibrils (~90%), glycoproteins, proteoglycans, and extracellular fluid.

Newer studies have mainly employed high-performance liquid chromatography (HPLC) and recently also liquid chromatography–tandem mass spectrometry (LC–MS/MS), offering improved sensitivity and specificity. HPLC was shown to be generally superior to bioassays when analyzing bone samples [5]. Bone ­penetration studies should report details on the chosen methods for sample preparation and analysis, and the recovery, bias, and precision. Concentrations in bone are typically reported as mg/kg of total bone mass.

Therefore studying the time course and extent of bone penetration before launching a clinical effectiveness trial is important. The aim of this chapter is to review the pharmacokinetics (PK) and pharmacodynamics (PD) of antibiotics in bone and present methods that support optimized evidence-based selection of antibiotic dosage regimens. Pharmacokinetics Time course and magnitude of drug concentrations in the body and particularly at the site of action determine the drug effects. Therefore it is important to study PK, which describes the relationship between the dose of a drug and the resulting time course of drug concentrations at various spaces in the body [2, 3].

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