Prolonged Antimicrobial Activity of PMMA Bone Cement with Embedded Gentamicin-Releasing Silica Nanocarriers

Abstract

Antibiotic laden bone cements are regularly employed to prevent infections after joint replacement surgeries. We have developed silica nanocarriers loaded with gentamicin as a drug delivery systems to be dispersed in Poly-methyl-methacrylate (PMMA) bone cement for controlling and extending the release of the antibiotic from bone cements, thus proving a prolonged antimicrobial activity,. Layerby-Layer self-assembly was used to deposit gentamicin between alginate layers and two different Poly-beta-amino esters on the silica nanoparticles. The release of gentamicin from PMMA bone cement containing silica nanocarriers continued for about 30 days compared to 6 days when the same amount of antibiotic was added as pure powder (as in commercial formulations); moreover the media containing the released antimicrobial drug was capable of preventing the growth of numerous bacteria species responsible for prosthetic joint infections (both catalogue strains and clinical isolates) for longer periods of time than in case of commercial formulation; thus confirming the extended antimicrobial properties of the drug once released from the carrier. No detrimental effects toward human osteoblasts were also observed; moreover bone cement material characteristics such as curing time, water uptake and mechanical properties were unaffected when the silica nanocarriers were added. 6 Supporting information Generalised linear models, fitting results (coefficients, plots, residues), gentamicin MIC of the bacterial species employed.

Physico-Chemical Characterization and Antimicrobial Properties of Hybrid Film Based on Saponite and Phloxine B

“…Disinfection with quaternary alkylammonium salts, hydrogen peroxide, or sodium hypochlorite has been in use for many years [ 15 ], while the surface modification of medical equipment with nanoparticles is currently in high demand [ 16 , 17 , 18 ]. Additionally, nanoparticles are good carriers for antimicrobial drugs; for example, gentamicin carried by silica nanoparticles [ 19 ] or poly(ethylene)glycol-poly(β-amino esters) micelles conjugated with triclosan demonstrated an effective reduction in Gram-positive as well as Gram-negative bacteria [ 20 ]. Some nanoparticles such as the carboxyl-grafted superparamagnetic iron oxide nanoparticles were applied directly for disruption of biofilms [ 21 ].…”

A call for action to the biomaterial community to tackle antimicrobial resistance

“…The rationale behind current antibiotic elution processes stems from the necessity to rapidly eliminate latent bacteria attached to the implant or introduced during surgery (exogenous). 235 These early or delayed infections are developed during the initial 3 to 24 months after implantation and commonly require a high concentration of antibiotic in the following week after surgery. Thus, the use of elution profiles in the form of high dosage peaks during the first days, which rapidly decay in the coming week but with maintained antibiotic levels still present a…”

Progress of antibiotic-loaded bone cement in joint arthroplasty

“…In vitro experiments investigating this additive showed an increase in the drug release rate, total elution, and antimicrobial activity, with no significant changes in mechanical performance or biocompatibility. [ 48 – 50 ] Calcium polyphosphate, an analog of bone tissue, extended the elution time, with a significant decrease in the initial elution and maintenance of bioactivity. [ 51 ] When coated on PMMA in combination with alginate-chitosan nanoparticles, vancomycin prolonged drug elution for 60 days.…”