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A Unique Drug for a Unique Infection

Dani-Margot Zavasky, MD; Merle A. Sande, MD

JAMA. 1998;279:1575-1577.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Implantation of foreign materials in the form of fixation devices and prosthetic joints has revolutionized the orthopedic surgical field in the last decades. These indisputable technological advances and sophisticated devices, although usually highly successful and devoid of complications, pose a challenging problem if they succumb to infection. Effective treatment of infections of implanted orthopedic devices has been extremely difficult regardless of repeated revision surgeries and prolonged courses of antimicrobials.

The unique microenvironment created around the implant is primarily responsible for the difficulty in eradicating microorganisms from the site of infection. Both microbial pathogenic factors and host responses contribute to this environment, which leads to protection of the organism from clearance by host defenses and from antimicrobial access. Most microorganisms that infect prosthetic devices produce an adhesive substance called glycocalyx that adheres to the foreign material and forms a protective barrier that allows the . . . [Full Text of this Article]

From the Department of Internal Medicine, University of Utah Health Science Center, Salt Lake City.

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