In Vitro Elution Characteristics of Gentamicin and Vancomycin from Synthetic Bone Graft Substitutes

Maier, Gerrit Steffen; Roth, Klaus Edgar; Andereya, S.; Birnbaum, Klaus; Niedhart, Christopher; Lühmann, Markus; Ohnsorge, J. A. K.; Maus, Uwe

doi:10.2174/1874325001307010624

Cited by 17 publications

(13 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 13 ] Owing to the obvious systemic toxicity by systemic administration, local application of vancomycin is increasingly being adopted to decrease the toxic side effects. [ 17 18 ]…”

Section: Discussionmentioning

confidence: 99%

Biosafety of the Novel Vancomycin-loaded Bone-like Hydroxyapatite/Poly-amino Acid Bony Scaffold

Cao

Jiang

Yan

et al. 2016

Chinese Medical Journal

View full text Add to dashboard Cite

Background:Recently, local sustained-release antibiotics systems have been developed because they can increase local foci of concentrated antibiotics without increasing the plasma concentration, and thereby effectively decrease any systemic toxicity and side effects. A vancomycin-loaded bone-like hydroxyapatite/poly-amino acid (V-BHA/PAA) bony scaffold was successfully fabricated with vancomycin-loaded poly lactic-co-glycolic acid microspheres and BHA/PAA, which was demonstrated to exhibit both porosity and perfect biodegradability. The aim of this study was to systematically evaluate the biosafety of this novel scaffold by conducting toxicity tests in vitro and in vivo.Methods:According to the ISO rules for medical implant biosafety, for in vitro tests, the scaffold was incubated with L929 fibroblasts or rabbit noncoagulant blood, with simultaneous creation of positive control and negative control groups. The growth condition of L929 cells and hemolytic ratio were respectively evaluated after various incubation periods. For in vivo tests, a chronic osteomyelitis model involving the right proximal tibia of New Zealand white rabbits was established. After bacterial identification, the drug-loaded scaffold, drug-unloaded BHA/PAA, and poly (methyl methacrylate) were implanted, and a blank control group was also set up. Subsequently, the in vivo blood drug concentrations were measured, and the kidney and liver functions were evaluated.Results:In the in vitro tests, the cytotoxicity grades of V-BHA/PAA and BHA/PAA-based on the relative growth rate were all below 1. The hemolysis ratios of V-BHA/PAA and BHA/PAA were 2.27% and 1.42%, respectively, both below 5%. In the in vivo tests, the blood concentration of vancomycin after implantation of V-BHA/PAA was measured at far below its toxic concentration (60 mg/L), and the function and histomorphology of the liver and kidney were all normal.Conclusion:According to ISO standards, the V-BHA/PAA scaffold is considered to have sufficient safety for clinical utilization.

show abstract

“…[ 13 ] Owing to the obvious systemic toxicity by systemic administration, local application of vancomycin is increasingly being adopted to decrease the toxic side effects. [ 17 18 ]…”

Section: Discussionmentioning

confidence: 99%

Biosafety of the Novel Vancomycin-loaded Bone-like Hydroxyapatite/Poly-amino Acid Bony Scaffold

Cao

Jiang

Yan

et al. 2016

Chinese Medical Journal

View full text Add to dashboard Cite

show abstract

“…The reported antibiotic elution profiles of different bioceramics remain fairly similar, with the majority of carriers delivering antibiotics above the minimum inhibitory concentrations for between 3-4 weeks. The two principle exceptions to this are the studies of Rauschmann et al 57 and Maier et al 58 , where the antibiotic elution was significantly shorter, tailing off at 10 and 6 days respectively. This difference might be explained by the fact that in these papers, the antibiotics were added to the pre-formed ceramic pellets rather that during the ceramic mixing phase before final setting.…”

Section: Antibiotic Elution Profiles Of Ceramic Antibiotic Carriersmentioning

confidence: 96%

Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections

Ferguson

Diefenbeck

McNally

2017

J. Bone Joint Infect.

135

153

View full text Add to dashboard Cite

Local release of antibiotic has advantages in the treatment of chronic osteomyelitis and infected fractures. The adequacy of surgical debridement is still key to successful clearance of infection but local antibiotic carriers seem to afford greater success rates by targeting the residual organisms present after debridement and delivering much higher local antibiotic concentrations compared with systemic antibiotics alone. Biodegradable ceramic carriers can be used to fill osseous defects, which reduces the dead space and provides the potential for subsequent repair of the osseous defect as they dissolve away. A dissolving ceramic antibiotic carrier also raises the possibility of single stage surgery with definitive closure and avoids the need for subsequent surgery for spacer removal.In this article we provide an overview of the properties of various biodegradable ceramics, including calcium sulphate, the calcium orthophosphate ceramics, calcium phosphate cement and polyphasic carriers. We summarise the antibiotic elution properties as investigated in previous animal studies as well as the clinical outcomes from clinical research investigating their use in the surgical management of chronic osteomyelitis.Calcium sulphate pellets have been shown to be effective in treating local infection, although newer polyphasic carriers may support greater osseous repair and reduce the risk of further fracture or the need for secondary reconstructive surgery. The use of ceramic biocomposites to deliver antibiotics together with BMPs, bisphosphonates, growth factors or living cells is under investigation and merits further study.We propose a treatment protocol, based on the Cierny-Mader classification, to help guide the appropriate selection of a suitable ceramic antibiotic carrier in the surgical treatment of chronic osteomyelitis.

show abstract

“…Maier et al 89 compared the beta tricalcium phosphates Cerasorb ® and Cerasorb ® M as antibiotic carrier systems impregnated with gentamycin and vancomycin. They reported elution rates for both materials over the MIC of S. aureus.…”

Section: Compositesmentioning

confidence: 99%

Eluting antibiotic bone graft substitutes for the treatment of osteomyelitis in long bones. A review: evidence for their use?

Schlickewei¹,

Yarar²,

Rueger³

2014

ORR

View full text Add to dashboard Cite

Despite continuous advances in surgical procedures and antibiotic therapies, osteomyelitis still remains one of the most devastating complications in trauma and orthopedic surgery. Treatment of osteomyelitis represents a severe and challenging problem, even if the treatment of acute cases with systemic antibiotics has good success rates. Chronic cases need a consequent resection of dead or infected bone in addition to an improved systemic and local antibiotic therapy. The gold standard therapy is the implantation of polymethylmethacrylate as spacer and local antibiotic carrier. Besides other drawbacks, nonbiodegradable polymethylmethacrylate implants need to be removed. This led to an ongoing search for a biodegradable antibiotic bone graft substitute for the treatment of osteomyelitis to avoid secondary removal. The number of clinically available products grows, but still, the available number of peer-reviewed clinical trials to prove their efficiency is limited. This review gives an overview of the current available literature.

show abstract

In Vitro Elution Characteristics of Gentamicin and Vancomycin from Synthetic Bone Graft Substitutes

Cited by 17 publications

References 23 publications

Biosafety of the Novel Vancomycin-loaded Bone-like Hydroxyapatite/Poly-amino Acid Bony Scaffold

Biosafety of the Novel Vancomycin-loaded Bone-like Hydroxyapatite/Poly-amino Acid Bony Scaffold

Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections

Eluting antibiotic bone graft substitutes for the treatment of osteomyelitis in long bones. A review: evidence for their use?

Contact Info

Product

Resources

About