Daptomycin: Local Application in Implant-Associated Infection and Complicated Osteomyelitis

Roßlenbroich, Steffen; Raschke, Michael J.; Kreis, Carolin; Tholema-Hans, Nancy; Uekoetter, Andreas; Reichelt, Rudolf; Fuchs, Thomas

doi:10.1100/2012/578251

Cited by 14 publications

(12 citation statements)

References 52 publications

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“…Rosslenbroich et al. used a continuous flow chamber to check elution kinetics, and the bacteria tested were S. epidermidis and E. faecium only . Elution of antibiotics from acrylic cement was thought to be a surface phenomenon and little of the antibiotic contained within the matrix was released .…”

Section: Discussionmentioning

confidence: 99%

Daptomycin‐Loaded Polymethylmethacrylate Bone Cement for Joint Arthroplasty Surgery

et al. 2013

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Antibiotic-loaded acrylic bone cement has been frequently used as an infection prophylaxis or antibiotic-loaded spacer in infected arthroplasty. In addition, daptomycin has been used recently against broad spectrum Gram-positive organisms. The goal of this in vitro study is to investigate the bacteriacidal and mechanical properties of daptomycin-incorporated polymethylmethacrylate (PMMA) bone cement and evaluate its feasibility for clinical use. Daptomycin (0.5, 1, or 2 g) was premixed with 40 g of PMMA bone cement powder before curing. The mechanical properties of the daptomycin-loaded acrylic bone cement (DLABC) were estimated following standard guidance, and the release profile and kinetics of daptomycin from PMMA were analyzed. The antimicrobial efficacy of DLABC was determined with a zone of inhibition (ZOI) assay against Staphylococcus aureus, Staphylococcus epidermis, Enterococcus faecalis, and Enterococcus faecium, respectively. The results showed that the compressive strength, of PMMA bone cement, which was higher than 100 MPa in all groups, was sufficient according to ISO 5833 after incorporation of daptomycin. The encapsulated daptomycin was released for 2 weeks with a 9.59 ± 0.85%, 15.25 ± 0.69%, and 20.64 ± 20.33% released percentage on the first day in the low, mid, and high groups, respectively. According to the calculated release kinetics, incorporated daptomycin should be 3.3 times the original dose to double its release. Although all recipes of DLABC had a microbial inhibitory effect, the effect with a higher encapsulated amount of daptomycin was more significant. Therefore, we believe that daptomycin can be locally delivered from PMMA bone cement at the surgical site as a prophylactic or treatment for osteomyelitis against Gram-positive organisms with intact cement function.

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Section: Discussionmentioning

confidence: 99%

Daptomycin‐Loaded Polymethylmethacrylate Bone Cement for Joint Arthroplasty Surgery

et al. 2013

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“…71 Recently, daptomycin has also been recommended as a new option for the treatment of implant infections, 68 due to its good effect systemically and locally against methicillin-resistant staphylococci and enterococci in patients with implant-associated infections. 72,73 By using such antibiotic treatment, prosthetic knee-associated infections in many patients could be well controlled. 42 Soriano et al ., 74 in a study of 85 patients with orthopedic implant infections, reported that 47- and 60-day treatment with linezolid showed a 72.2% and a 42.8% success rate in acute and chronic infections, respectively, when the implant was not removed.…”

Section: Treatment Of Prosthesis-related Infectionsmentioning

confidence: 99%

Prosthesis infections after orthopedic joint replacement: the possible role of bacterial biofilms

et al. 2013

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Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore, important to understand the comprehensive interaction between the microbiological situation and the host immune responses that lead to prosthesis infections. Evidence indicates that prosthesis infections are actually biofilm-correlated infections that are highly resistant to antibiotic treatment and the host immune responses. The authors reviewed the related literature in the context of their clinical experience, and discussed the possible etiology and mechanism leading to the infections, especially problems related to bacterial biofilm, and prophylaxis and treatment of infection, including both microbiological and surgical measures. Recent progress in research into bacterial biofilm and possible future treatment options of prosthesis-related infections are discussed.

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“…One potential therapeutic strategy is local drug delivery where antibiotics delivered locally at the implant site in high concentration can take care of pathogenic bacteria. This can be achieved either by using an adequate carrier or by coating the implants (stainless steel or titanium implants) with polymers loaded with antimicrobial agent [ 11 – 13 ]. Large number of delivery strategies have been used till date.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Assessment of Phage and Linezolid Based Implant Coatings for Treatment of Methicillin Resistant S. aureus (MRSA) Mediated Orthopaedic Device Related Infections

2016

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Staphylococcus comprises up to two-thirds of all pathogens in orthopaedic implant infections with two species respectively Staphylococcus aureus and Staphylococcus epidermidis, being the predominate etiological agents isolated. Further, with the emergence of methicillin-resistant S. aureus (MRSA), treatment of S. aureus implant infections has become more difficult, thus representing a devastating complication. Use of local delivery system consisting of S.aureus specific phage along with linezolid (incorporated in biopolymer) allowing gradual release of the two agents at the implant site represents a new, still unexplored treatment option (against orthopaedic implant infections) that has been studied in an animal model of prosthetic joint infection. Naked wire, hydroxypropyl methylcellulose (HPMC) coated wire and phage and /or linezolid coated K-wire were surgically implanted into the intra-medullary canal of mouse femur bone of respective groups followed by inoculation of S.aureus ATCC 43300(MRSA). Mice implanted with K-wire coated with both the agents i.e phage as well as linezolid (dual coated wires) showed maximum reduction in bacterial adherence, associated inflammation of the joint as well as faster resumption of locomotion and motor function of the limb. Also, all the coating treatments showed no emergence of resistant mutants. Use of dual coated implants incorporating lytic phage (capable of self-multiplication) as well as linezolid presents an attractive and aggressive early approach in preventing as well as treating implant associated infections caused by methicillin resistant S. aureus strains as assessed in a murine model of experimental joint infection.

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Daptomycin: Local Application in Implant-Associated Infection and Complicated Osteomyelitis

Cited by 14 publications

References 52 publications

Daptomycin‐Loaded Polymethylmethacrylate Bone Cement for Joint Arthroplasty Surgery

Daptomycin‐Loaded Polymethylmethacrylate Bone Cement for Joint Arthroplasty Surgery

Prosthesis infections after orthopedic joint replacement: the possible role of bacterial biofilms

In Vivo Assessment of Phage and Linezolid Based Implant Coatings for Treatment of Methicillin Resistant S. aureus (MRSA) Mediated Orthopaedic Device Related Infections

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