{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:21:32Z","timestamp":1792070492664,"version":"4.4.0"},"reference-count":54,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>This international, multi-center study evaluated the effect of antibiotic-loaded carriers (ALCs) on outcome in patients with a fracture-related infection (FRI) and evaluated whether bacterial resistance to the implanted antibiotics influences their efficacy. All patients who were retrospectively diagnosed with FRI according to the FRI consensus definition, between January 2015 and December 2019, and who underwent surgical treatment for FRI at any time point after injury, were considered for inclusion. Patients were followed-up for at least 12 months. The primary outcome was the recurrence rate of FRI at follow-up. Inverse probability for treatment weighting (IPTW) modeling and multivariable regression analyses were used to assess the relationship between the application of ALCs and recurrence rate of FRI at 12 months and 24 months. Overall, 429 patients with 433 FRIs were included. A total of 251 (58.0%) cases were treated with ALCs. Gentamicin was the most frequently used antibiotic (247\/251). Recurrence of infection after surgery occurred in 25\/251 (10%) patients who received ALCs and in 34\/182 (18.7%) patients who did not (unadjusted hazard ratio (uHR): 0.48, 95% CI: [0.29\u20130.81]). Resistance of cultured microorganisms to the implanted antibiotic was not associated with a higher risk of recurrence of FRI (uHR: 0.75, 95% CI: [0.32\u20131.74]). The application of ALCs in treatment of FRI is likely to reduce the risk of recurrence of infection. The high antibiotic concentrations of ALCs eradicate most pathogens regardless of susceptibility test results.<\/jats:p>","DOI":"10.3390\/antibiotics11101330","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T21:03:10Z","timestamp":1664485390000},"page":"1330","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Does the Use of Local Antibiotics Affect Clinical Outcome of Patients with Fracture-Related Infection?"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0176-112X","authenticated-orcid":false,"given":"Jonathan","family":"Sliepen","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth A.","family":"Corrigan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford OX3 9DU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Dudareva","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford OX3 9DU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"Wouthuyzen-Bakker","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3513-5936","authenticated-orcid":false,"given":"Rob J.","family":"Rentenaar","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget L.","family":"Atkins","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford OX3 9DU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6033-1835","authenticated-orcid":false,"given":"Geertje A. M.","family":"Govaert","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2003-9044","authenticated-orcid":false,"given":"Martin A.","family":"McNally","sequence":"additional","affiliation":[{"name":"The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford OX3 9DU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9420-2732","authenticated-orcid":false,"given":"Frank F. 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