Antibiotic Release From Impregnated Pellets and Beads

Bowyer, Gavin; Cumberland, Nigel

doi:10.1097/00005373-199403000-00008

Cited by 71 publications

(60 citation statements)

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“…Bowyer and Cumberland conducted a similar test comparing only PMMA and calcium sulfate but with a wider variety of antibiotics and determined that calcium sulfate pellets compared favorably with PMMA beads, releasing four times as much antibiotic as PMMA during an initial 24-h period. 21 Grimsrud et al examined the elution of voriconazole, a broad-spectrum antifungal, from PMMA and calcium sulfate (Osteoset, Wright Medical Techology) and found very similar concentrations of antimicrobial from both substances at 48 h, 1 week, and 2 weeks. 22 Most recently, Udomkusonsri et al compared three varieties of PMMA (Cemfix, Depuy I, and SmartSet HV) with pure calcium sulfate and found that the total elution of cefazolin from calcium sulfate was greater than any of the PMMA types during the 15-day study, and the daily elution of calcium sulfate was significantly (p < 0.05) higher than the PMMA on days 1-11.…”

Section: Discussionmentioning

confidence: 99%

Comparing PMMA and calcium sulfate as carriers for the local delivery of antibiotics to infected surgical sites

McConoughey

Howlin

Wiseman

et al. 2014

J. Biomed. Mater. Res.

103

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Antibiotic-loaded bone cement is a primary option for treatment of orthopedic infections. Poly(methyl methacrylate) (PMMA) is a widely used cement that, when loaded with antibiotics in spacer or bead form, has been shown to reduce infection rates. However, PMMA is not resorbable and requires a second surgery for removal, while also acting as a potential foreign body for bacterial colonization. Alternatively, resorbable bone cements, such as calcium sulfate, have been proposed and present the advantage of being completely reabsorbed. It is unknown whether the antibiotic elution characteristics of absorbable bone cements are similar to PMMA. This study (1) characterized antibiotic elution from synthetic, highly purified calcium sulfate cement beads of varying sizes against pathogenic bacteria both in liquid culture and seeded on agar plates, (2) tested calcium sulfate beads against PMMA beads loaded with the same antibiotics, and (3) analyzed the structural differences between how PMMA and calcium sulfate bind to antibiotics. In every assay, the calcium sulfate beads performed as well as, or better than, the PMMA beads in inhibition of bacterial growth and elution of vancomycin in vitro with complete elution observed from calcium sulfate within three days. These data suggest that calcium sulfate, functions, as well as PMMA in the patient setting for infection control.

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Section: Discussionmentioning

confidence: 99%

Comparing PMMA and calcium sulfate as carriers for the local delivery of antibiotics to infected surgical sites

McConoughey

Howlin

Wiseman

et al. 2014

J. Biomed. Mater. Res.

103

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“…The procedures used for the elution studies were similar to those previously reported (Picknell 1977;Miclau 1993;Bowyer 1994;Ethell 2000). The PMMA- …”

Section: Methodsmentioning

confidence: 93%

“…PBS was used as the medium for antibiotic elution, because of successful results obtained with it in previous studies (Miclau 1993;Bowyer 1994;Ethell 2000). Due to its availability, phosphate buffered saline is more practical than serum for use in in vitro studies.…”

Section: Discussionmentioning

confidence: 99%

“…Plaster of Paris (PoP) is a commercially available and inexpensive material that has also been evaluated and used as a drug delivery system (DDS). This product consists mainly of calcium sulphate and its ability to release antibiotics has been shown to be a four-fold greater than that of PMMA (Bowyer 1994).…”

Section: Biodegradable Drug Delivery Systems (Bdds)mentioning

confidence: 99%

“…The lack of elution from PMMA may be due to the fact that they are not sufficiently heat stable and may not be able to retain activity after the exothermic polymerization reaction (up to 100°C) (Calhoun 1989;Popham 1991;Kanellakopoulou 2000). Despite having little heat stability, penicillins have been shown to elute at acceptable concentrations (Picknell 1977;Bowyer 1994). In addition to penicillins, other antibiotics demonstrated to readily elute from PMMA include cephalosporins, 15 aminoglycosides, fucidic acid, clindamycin, lincomycin and streptomycin (Picknell 1977;Popham 1991).…”

Section: )mentioning

confidence: 99%

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Elution of Metronidazole and Gentamicin from Polymethylmethacrylate Beads

et al. 2003

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(ABSTRACT)Ten polymethylmethacrylate (PMMA) beads containing metronidazole (3 concentrations); gentamicin sulfate; or metronidazole and gentamicin sulfate were immersed in 5 ml of phosphate buffered saline in triplicate. Eluent was replaced at specified time intervals for 1 day (1, 3, 6, 12 and 24 hours), daily, or weekly for 21 days.Antibiotic concentrations were measured by High Performance Liquid Chromatography.Changes in antibiotic bioactivity attributable to polymerization or co-polymerization of the antibiotics with PMMA, ethylene oxide sterilization, and storage of antibioticimpregnated PMMA (AIPMMA) beads containing metronidazole were evaluated.Antibiotic elution patterns were similar for all groups. Day-1 elution for groups containing either metronidazole (3 concentrations) or gentamicin represented a mean 63% to 66% and 79% respectively of the 21-day total elution. Approximately 50% of the day-1 elution occurred during the first hour. The elution of metronidazole was dosedependent. There was no significant difference in the total amount of antibiotic eluted from groups that had the saline changed daily versus weekly. The elution of metronidazole (day 3-21) and gentamicin (all days) was significantly greater when metronidazole and gentamicin were combined (p<0.05). Polymerization of PMMA was delayed in groups containing metronidazole.Neither polymerization nor copolymerization of metronidazole and gentamicin with PMMA, gas-sterilization, or 2-month storage of beads containing metronidazole significantly affected antimicrobial bioactivity.Metronidazole elutes from PMMA. The frequency at which the saline was changed did not affect the rate of antibiotic elution.

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Osteomyelitis

Goodrich¹

2019

Equine Fracture Repair

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Antibiotic Release From Impregnated Pellets and Beads

Cited by 71 publications

References 0 publications

Comparing PMMA and calcium sulfate as carriers for the local delivery of antibiotics to infected surgical sites

Comparing PMMA and calcium sulfate as carriers for the local delivery of antibiotics to infected surgical sites

Elution of Metronidazole and Gentamicin from Polymethylmethacrylate Beads

Osteomyelitis

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