Investigating the in vitro antibacterial efficacy of composite bone cement incorporating natural product-based monomers and gentamicin

Abstract

Objective The objective of this study is to investigate the impact of four natural product extracts, namely, aloe-emodin, quercetin, curcumin, and tannic acid, on the in vitro bacteriostatic properties and biocompatibility of gentamicin-loaded bone cement and to establish an experimental groundwork supporting the clinical utility of antibiotic-loaded bone cements (ALBC). Methods Based on the components, the bone cement samples were categorized as follows: the gentamicin combined with aloe-emodin group, the gentamicin combined with quercetin group, the gentamicin combined with curcumin group, the gentamicin combined with tannic acid group, the gentamicin group, the aloe-emodin group, the quercetin group, the curcumin group, and the tannic acid group. Using the disk diffusion test, we investigated the antibacterial properties of the bone cement material against Staphylococcus aureus (n = 4). We tested cell toxicity and proliferation using the cell counting kit-8 (CCK-8) and examined the biocompatibility of bone cement materials. Results The combination of gentamicin with the four natural product extracts resulted in significantly larger diameters of inhibition zones compared to gentamicin alone, and the difference was statistically significant (P < 0.05). Except for the groups containing tannic acid, cells in all other groups showed good proliferation across varying time intervals without displaying significant cytotoxicity (P < 0.05). Conclusion In this study, aloe-emodin, quercetin, curcumin, and tannic acid were capable of enhancing the in vitro antibacterial performance of gentamicin-loaded bone cement against S. aureus. While the groups containing tannic acid displayed moderate cytotoxicity in in vitro cell culture, all other groups showed no discernible cytotoxic effects.

Effect of Gentamicin Sulfate and Polymeric Polyethylene Glycol Coating on the Degradation and Cytotoxicity of Iron-Based Biomaterials

“…Gentamicin sulfate is an aminoglycoside antibiotic used mainly to deal with bone infections due to its relatively broad antimicrobial spectrum and high thermostability. ,, Research by Nichol et al revealed that the addition of gentamicin to a monolayer organic–inorganic hybrid sol–gel coating completely eradicated planktonic bacteria as well as biofilms of a panel of clinically relevant staphylococci, while such a coating did not interfere with bone healing . Likewise, high- and long-term doses of gentamicin can trigger serious adverse reactions in the surrounding nerves, so it is important to choose only the necessary concentration of the drug for the given time . Since bacterial colonization usually occurs in the first hours after material implantation, short-term systemic prophylaxis is as effective as long-term prevention.…”

“… 26 Likewise, high- and long-term doses of gentamicin can trigger serious adverse reactions in the surrounding nerves, so it is important to choose only the necessary concentration of the drug for the given time. 27 Since bacterial colonization usually occurs in the first hours after material implantation, short-term systemic prophylaxis is as effective as long-term prevention. In fact, a short-term local drug delivery system can meet the requirements to prevent local infection while limiting possible long-term adverse side effects.…”