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. 2025 Jul 2;14(7):601-608.
doi: 10.1302/2046-3758.147.BJR-2024-0508.R1.

Impact of tranexamic acid on the efficacy of vancomycin and meropenem against periprosthetic joint infections : an in vitro analysis

Liqin Yao  1 , Youcai Ma  2 , Qiangde Hu  3 , Rui Liu  3 , Boyong Xu  3 , Xuebin Sun  2 , Li Cao  3   4   5 , Wenbo Mu  3
Affiliations

Impact of tranexamic acid on the efficacy of vancomycin and meropenem against periprosthetic joint infections : an in vitro analysis

Liqin Yao et al. Bone Joint Res. .

Abstract

Aims: This study investigated the effects of tranexamic acid (TXA) on the efficacy of vancomycin and meropenem against common periprosthetic joint infection (PJI)-associated pathogens in vitro. The aim was to uncover valuable insights that can be used for clinical decision-making and enhanced management of PJI in orthopaedic surgery.

Methods: We evaluated the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum biofilm inhibitory concentration (MBIC), and minimum biofilm eradication concentration (MBEC) for vancomycin and meropenem, both with and without TXA, against various bacterial strains.

Results: In the planktonic bacterial phase, TXA increased the MIC and MBC of vancomycin for Staphylococcus aureus and Staphylococcus epidermidis, decreased the MIC and MBC of meropenem for S. aureus, and increased the MIC and MBC of vancomycin combined with meropenem for S. aureus. In biofilms, TXA in combination with vancomycin synergistically decreased the MBIC and MBEC values of methicillin-resistant S. aureus (MRSA) and S. aureus.

Conclusion: TXA influences antibiotic efficacy against both planktonic bacteria and biofilms, with effects varying by antibiotic and bacterial strain. These findings underscore the complexity of drug interactions in PJI treatment, highlighting the need for tailored therapeutic strategies based on strain-specific responses.

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Conflict of interest statement

All authors report grants from the Second Batch of the Tianshan Talent Cultivation Program for Young Promising Talents (2023TSYCQNTJ0003), National Natural Science Foundation of China (82260435), Major Special Projects of Science and Technology Plan of Xinjiang Uygur Autonomous Region (2022A03011), Science and Technology Innovation Team Project of Xinjiang Uygur Autonomous Region Science and Technology Department (2023TSYCTD0014), and Key Laboratory of High Incidence Disease Research in Xinjiang (Xinjiang Medical University), Ministry of Education-Key project (2023A01), related to this study. The authors have no other relevant financial or non-financial interests to disclose, and the final manuscript has been approved by all authors for publication.

Figures

Fig. 1
Fig. 1
Flow diagram of experiment. a) Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) processes of planktonic bacterial stages in response to antibiotics and tranexamic acid (TXA). b) Minimum biofilm inhibitory concentration (MBIC) and minimum biofilm eradication concentration (MBEC) processes of biofilm stages in response to antibiotics and TXA. CFU, colony-forming units; MEM, meropenem; VAN, vancomycin.
See this image and copyright information in PMC

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