Treatment of chronic osteomyelitis using calcium hydroxyapatite ceramic implants impregnated with antibiotic

Yamashita, Yoshiki; Uchida, Atsushi; Yamakawa, Toru; Shinto, Yoshitaka; Araki, Nobuto; Kato, Ko

doi:10.1007/s002640050252

Cited by 102 publications

(62 citation statements)

References 14 publications

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“…25,33,34 PMMA has been the most widely evaluated material for use as a bone cement. 28,32,35 Various types of methylmethacrylate have been tested in elution studies. 36 -39 The shape of the methylmethacrylate implant, together with the type of methylmethacrylate, has a significant effect on the amount of antibiotic that is delivered and the duration of delivery.…”

Section: 29mentioning

confidence: 99%

Calcium Sulphate Delivery System with Tobramycin for the Treatment of Chronic Calcaneal Osteomyelitis

et al. 2006

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The case of a 24-year-old woman with Pseudomonas aeruginosa and Proteus mirabilis chronic calcaneal osteomyelitis is presented. Extensive debridement of the necrotic bone and application of tobramycin-loaded polymethylmethacrylate beads was performed and ciprofloxacin was given post-operatively. Three months later, laboratory tests, including complete blood cell count, erythrocyte sedimentation rate and C-reactive protein, were normal. At this time, extensive surgical debridement and filling of the osseous defect with autologous iliac cancellous bone graft and tobramycin-impregnated calcium sulphate pellets and paste were performed. Oral ciprofloxacin was administered for 3 months after surgery. At the latest follow-up, 2 years later, the patient had full weight-bearing function; there was no recurrence of the infection, and complete incorporation of the autologous bone and calcium sulphate graft with the host bone was observed. This case demonstrates that two-stage surgical treatment with extensive debridement and tobramycinimpregnated calcium sulphate was effective in treating chronic calcaneal osteomyelitis.

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Section: 29mentioning

confidence: 99%

Calcium Sulphate Delivery System with Tobramycin for the Treatment of Chronic Calcaneal Osteomyelitis

et al. 2006

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“…Owing to its bioactive property, HA is widely used in medicine and dentistry as a material for metallic implant coatings, or for bone cavity fillings [2,3]. In addition, HA can be used as drug delivery agent, such as for the delivery of antitumor agents and antibodies in the treatment of osteomyelitis: a bone infection that is often treated by excision of necrotic tissue and irrigation of the wound [4]. Potential use of HA as a protein delivery agent was also examined [5].…”

Section: Introductionmentioning

confidence: 99%

Template-Based Synthesis of Nanoporous Hydroxyapatite

2012

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Hydroxyapatite (HAp) particles, a potential starting material for bone substitutes, with nanopores were synthesized in the presence of cetyltrimethylammonium bromide (CTAB) and P123 as cationic and nonionic surfactants as the structuring units. Effect of nonionic surfactant concentration on surface areas is also investigated. Based on N 2 adsorption-desorption isotherms investigation, surface area increased up to 50 m 2 /g by using P123 and 147 m 2 /g by using CTAB as porosity agent. Pore structure remained even after the removal of surfactant and calcinations at 400 • C.

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“…Chronic osteomyelitis is an infection difficult to treat due both to multidrug resistance of common pathogens and to poor penetration of antibiotics into bone (16). Carriers for local delivery of antimicrobials have been developed, attempting to provide locally high concentrations of antibiotics (5).…”

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confidence: 99%

In Vitro Elution of Daptomycin by a Synthetic Crystallic Semihydrate Form of Calcium Sulfate, Stimulan

Kanellakopoulou¹,

Panagopoulos²,

Giannitsioti³

et al. 2009

Antimicrob Agents Chemother

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A synthetic crystallic semihydrate form of calcium sulfate, Stimulan, was evaluated as a biodegradable carrier for the daily in vitro elution of daptomycin. Daptomycin and Stimulan were admixed at a ratio of 95:5. Elution lasted for 28 days. Eluted concentrations peaked on days 1 and 11, when the mean values were 1,320.1 and 949.2 g/ml, respectively. The lowest eluted concentration was detected on day 28. These results support the application of the system described in experimental models of osteomyelitis.Chronic osteomyelitis is an infection difficult to treat due both to multidrug resistance of common pathogens and to poor penetration of antibiotics into bone (16). Carriers for local delivery of antimicrobials have been developed, attempting to provide locally high concentrations of antibiotics (5). Some newly developed biodegradable carriers have been shown to be very potent for the eradication of experimental osteomyelitis (6, 7). The semihydrate form of calcium sulfate (CaSO 4 ), commonly known as plaster of Paris, may be applied as a biodegradable system for local drug delivery. It has been used for decades to fill bone cavities resulting from disease, trauma, or surgery (11). It was recently shown to be potent in vitro for the release of vancomycin, teicoplanin, gentamicin, and clindamycin (15). The antimicrobial applied in such an elution system should be active against the most commonly involved pathogens of chronic bone infections, namely, methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (CoNS) (5). Daptomycin, which is a novel lipopeptide antimicrobial with excellent in vitro activity against these isolates (4), may be a candidate for application in a system for local drug delivery.Stimulan (Biocomposites, Keele Science Park, Staffordshire, United Kingdom) is a synthetic biocompatible bone graft material made of calcium sulfate. It is completely reabsorbed and replaced with new bone. It is synthesized at 100% purity with no traces of potentially toxic impurities that have been associated with naturally occurring mineral sources of calcium sulfate. It has been recently shown by our group that moxifloxacin and fusidic acid may be eluted at high concentrations in vitro by using Stimulan as a carrier (11). The purpose of the present study was to develop an in vitro system for daptomycin elution by using Stimulan as a delivery system. Stimulan was mixed with daptomycin (Novartis, Basel, Switzerland) at a ratio 95:5 to a total weight of 3 g. This was put into sterile vials (160 by 100 mm) and left at room temperature for 15 to 30 min for solidification. Five similar vials were prepared. One milliliter of Mueller-Hinton broth (Trec Diagnostic Systems, West Sussex, United Kingdom) was added over the free surface of each mixture and replaced every 24 h. The vials were incubated at 37°C. On each consecutive day, the eluent was removed, transferred to a sterile plastic tube, and replaced with 1 ml of broth. That procedure was repeated until the optical...

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Treatment of chronic osteomyelitis using calcium hydroxyapatite ceramic implants impregnated with antibiotic

Cited by 102 publications

References 14 publications

Calcium Sulphate Delivery System with Tobramycin for the Treatment of Chronic Calcaneal Osteomyelitis

Calcium Sulphate Delivery System with Tobramycin for the Treatment of Chronic Calcaneal Osteomyelitis

Template-Based Synthesis of Nanoporous Hydroxyapatite

In Vitro Elution of Daptomycin by a Synthetic Crystallic Semihydrate Form of Calcium Sulfate, Stimulan

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