Slow‐releasing potential of vancomycin‐loaded porous hydroxyapatite blocks implanted into MRSA osteomyelitis

Abstract

Although antibiotic-loaded hydroxyapatite blocks have been used for the treatment of chronic osteomyelitis, their long-term potential for releasing antibiotic into human bones is not well known. Five patients with chronic osteomyelitis due to methicillin-resistant Staphylococcus aureus (MRSA) infection were effectively treated with local implantation of vancomycin-loaded hydroxyapatite blocks. Blocks were removed during the following reconstructive surgeries when the releasing capability of the blocks, and the bacteriocidal activity of the remaining vancomycin in these blocks could be evaluated. Vancomycin was rapidly released within 1 month after implantation, and by 3 months 90% of vancomycin had leaked from the blocks. At 18 months vancomycin still remained in a bacteriocidal form in the hydroxyapatite blocks, though the blocks had no releasing potential or the eluted vancomycin had been changed to a different form. Vancomycin-loaded porous hydroxyapatite blocks would be useful for the treatment of chronic osteomyelitis or implant-associated osteomyelitis due to MRSA.

Modeling vancomycin release kinetics from microporous calcium phosphate ceramics comparing static and dynamic immersion conditions

“…Drug delivery systems for a clinical use are based on polymers, e.g. polymethylmethacrylate (PMMA) [6,7], degradable polylactic-co-glycolic acid (PLGA) [8,9], as well as on ceramic matrices like calcium phosphates (CaP) [10,11], nanoporous alumina (Al 2 O 3 ) [12,13] and silicon carbide (SiC) [14].…”

Examination of a Novel, Specified Local Antibiotic Therapy through Polymethylmethacrylate Capsules in a Rabbit Osteomyelitis Model

“…Recently, vancomycin-containing hydroxyapatite blocks were implanted into 5 patients suffering from osteomyelitis induced by methicillin-resistant S. aureus. Rapid and intensive antibiotic outfl ow was observed from the carrier in the fi rst 4 weeks, and 90% of the vancomycin was released within 3 months [19] . Experiments on the elution mechanism and release kinetics of gentamycin-containing bone cement revealed that the outfl ow of the antibiotic is slower from the deeper layers [1] .…”

Antimicrobial Biomimetics

“…www.intechopen.com polylactides (Mader et al, 1997;Schmidmaier et al, 2006), copolymers of lactide and glycolide (Mader et al, 1997;Ambrose et al, 2003), polycaprolactone (Burd et al, 2001;Le Rey et al, 2003), hydroxyapatite and glass ceramics (Saito et al, 2002;Makinen et al, 2005;Zalewska & Ginalska, 2009), calcium sulfate (Nelson et al, 2002), and fibrin sealant implants (Mader et al, 2002) have already been investigated for use as antibiotic delivery systems. Prevention and treatment of osteomyelitis, particularly associated with orthopaedic implant surgery, have been the focus of many studies, since in most surgical procedures that include the incorporation of implants, the tissue-implant surface is especially prone to microbial contamination.…”