Biological and Biomechanical Effects of Vancomycin and Meropenem in Acrylic Bone Cement

Sufficient Release of Antibiotic by a Spacer 6 Weeks after Implantation in Two-stage Revision of Infected Hip Prostheses

“…The use of two antibiotics results in a synergistic effect and the release of the individual components is greater than that of the single antibiotics on their own [2,6,29,31]. In our study, however, the addition of vancomycin did not result in an increase in the release of the antibiotics present in Copal bone cement, namely, gentamicin and clindamycin.…”

Antibiotic Loaded Acrylic Bone Cement in Orthopaedic Trauma

“…There still is no agreement concerning the choice or dose of the antibiotic to be mixed with the cement (Cerretani et al, 2002), as can be seen from the numerous published reports concerning vancomycin (Brien et al, 1993;Cerretani et al, 2002;Baleani et al, 2008), gentamicin, tobramycin (Brien et al, 1993)cephalosporins, clindamycin, ticarcillin, ciprofloxacin, amikacin, meropenem (Baleani et al, 2008), imipenem -cilastin (Cerretani et al, 2002) daptomycin and several others (Hanssen and Spangehl, 2004). Increasing bacterial resistance against common antibiotics, especially gentamycin, has lead to a demand for alternative drugs (Brien et al, 1993;Baleani et al, 2008;Hanssen and Spangehl, 2004;Hanssen, 2004).…”

“…Wahligs report also stated their experience with gentamicin loaded bone cement in forty-one patients with infection of either bone or soft tissue, mainly Acrylic bone cement was primarily developed as a fixation device for arthroplasty. When used for prosthesis fixation, mechanical properties of the antibiotic loaded acrylic cement need to be considered (Baleani et al, 2008;Persson et al, 2006). Because mechanical performances are not a major concern for spacers or cement beads (they are temporary solutions and in these cases the bone cement is not significantly loaded mechanically), the cement may in these cases can contain high antibiotic concentrations considering only its elution properties, microbiological efficiency, and safety (Baleani et al, 2008).…”

“…When used for prosthesis fixation, mechanical properties of the antibiotic loaded acrylic cement need to be considered (Baleani et al, 2008;Persson et al, 2006). Because mechanical performances are not a major concern for spacers or cement beads (they are temporary solutions and in these cases the bone cement is not significantly loaded mechanically), the cement may in these cases can contain high antibiotic concentrations considering only its elution properties, microbiological efficiency, and safety (Baleani et al, 2008). Sensitivity of bacteria is currently determined on the basis of effective serum levels achievable by systemic antibiotics.…”

A simple method for fashioning an antibiotic impregnated cemented rod for intramedullary placement in infected non-union of long bones

“…Several methods [6][7][8][9] of local antibiotic delivery system using PMMA are being commonly used which includes hand fashioned or commercially available PMMA beads, 10 PMMA rods [11][12][13] and PMMA coated nails. [1][2][3][4] None of these methods provide adequate stability and necessitates secondary procedure for stability at the fracture site in form of intramedullary interlocking nailing, cephalomedullary nailing or LCP with or without autogenous bone grafting.…”