Vancomycin Powder vs Gentamycin Sheets, Beads & Cement with Antibiotic in Early Implant Related Infection. A Comparative Study

Background: A wide range of implants are presently available to assist in restoring the structure or function of the musculoskeletal system. Aim: To study the use of vancomycin powder vs. gentamycin sheets with antibiotics in early implant-related infections, together with adequate debridement. Patients and methods: This study lasted two years, with a follow-up period of six months. This comparative study was conducted on thirty cases randomly allocated into two groups: In the vancomycin group, 15 patients were given antibiotics, vancomycin powder, and local gentamycin sheets. In the gentamycin group, 15 patients were given antibiotics and local gentamycin sheets, beads, and cement at Al-Hilal Hospital and Al-Hussein University Hospital. Results: There was an insignificant variance among the examined groups concerning the joint fluid aspirate, culture and sensitivity of the aspirate, the type of intervention, the follow-up period, and the outcome (wound healing, decreased ESR &CRP levels, complete recovery, inflammation, and re-infection). In addition, the onset of infection was not significantly different between the two groups. However, it is delayed because most patients were discharged early. Conclusion: Early, adequate, and aggressive debridement is the cornerstone for curing implant-associated infections. Our study's findings conclude that gentamycin sheets with antibiotics are slightly superior to vancomycin powder; however, vancomycin powder is more effective against Methicillin-resistant Staphylococcus aureus (MRSA).