Gentamicin‐loaded bone cement with clindamycin or fusidic acid added: Biofilm formation and antibiotic release

Neut, Daniëlle; Groot, Erik P. de; Kowalski, R.; Horn, J.R. van; Mei, Henny C. van der; Busscher, Henk J.

doi:10.1002/jbm.a.30253

Cited by 58 publications

(43 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is a broad choice of active molecules such as anticoagulants, antiinflammatory drugs, antibiotics and extracellular matrix proteins [2]. Several authors [4][5][6][7][8] reported that the adsorption of antibiotics (e.g., gentamicin, ciprofloxacin, amoxicillin, and erythromycin) on medical devices has a huge potential in the medical field. How-ever, there is a consensus in the medical area on the rational use of antibiotics in order to avoid microbial resistance.…”

Section: Introductionmentioning

confidence: 99%

Anti-sessile bacterial and cytocompatibility properties of CHX-loaded nanohydroxyapatite

Barros

Grenho

Fernandes

et al. 2015

Colloids and Surfaces B: Biointerfaces

View full text Add to dashboard Cite

Nanohydroxyapatite possesses exceptional biocompatibility and bioactivity regarding bone cells and tis-sues, justifying its use as a coating material or as a bone substitute. Unfortunately, this feature may also encourage bacterial adhesion and biofilm formation. Surface functionalization with antimicrobials is a promising strategy to reduce the likelihood of bacterial infestation and colonization on medical devices. Chlorhexidine digluconate is a common and effective antimicrobial agent used for a wide range of medical applications. The purpose of this work was the development of a nanoHA biomaterial loaded with CHX to prevent surface bacterial accumulation and, simultaneously, with good cytocompatibility, for application in the medical field. CHX (5-1500 mg/L) was loaded onto nanoHA discs and the materials were evaluated for CHX adsorption and release profile, physic-chemical features, antibacterial activity against Escherichia coli, Staphylococcus aureus and Staphylococcus epidermidis, and cytocompatibility toward L929 fibroblasts. Results showed that the adsorption of CHX on nanoHA surface occurred by electrostatic inter-actions between the cationic group of CHX and the phosphate group of nanoHA. The release of CHX from CHX-loaded nanoHA showed a fast initial rate followed by a slower kinetics release, due to constraints caused by dilution and diffusion-limiting processes. NanoHA.50 to nanoHA.1500 showed strong anti-sessile activity, inhibiting bacterial adhesion and the biofilm formation. CHX-nanoHA caused a dose-and time-dependent inhibitory effect on the proliferation of fibroblasts for nanoHA.100 to nanoHA.1500. Cellular behavior on 2 nanoHA.5 and nanoHA.50 was similar to control. Therefore, CHX-loaded nanoHA surfaces appear as a promising alternative to prevention of devices-related infections.

show abstract

Section: Introductionmentioning

confidence: 99%

Anti-sessile bacterial and cytocompatibility properties of CHX-loaded nanohydroxyapatite

Barros

Grenho

Fernandes

et al. 2015

Colloids and Surfaces B: Biointerfaces

View full text Add to dashboard Cite

show abstract

“…Second, we studied only several antibiotics and only one type of cement. Copal cement was used because antibiotic release from Copal of both antibiotics is greater and more prolonged and Copal is more effective in biofilm reduction than Palacos R-G cement or other cement [6,27]. The data we obtained with the antibiotics we studied are not necessarily relevant for other mixtures of antibiotics.…”

Section: Discussionmentioning

confidence: 95%

“…If the pathogens were resistant to one of these antibiotics, an extra 2 g vancomycin was added to 40 g Copal cement during the operation (seven cases). Copal cement was still used in these cases because antibiotic release from Copal of both antibiotics is prolonged and Copal is more effective in biofilm reduction compared with Palacos R-G or other cement [6,27].…”

Section: Methodsmentioning

confidence: 99%

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

Fink

Vogt

Reinsch

et al. 2011

Clinical Orthopaedics &Amp; Related Research

105

View full text Add to dashboard Cite

Background Although antibiotic-loaded spacers are commonly used to treat periprosthetic infections, it is unclear whether spacers continue to release bactericidal levels of antibiotic 6 weeks after implantation. Questions/purposes We asked whether an antibiotic can be detected in the tissue surrounding the spacer 6 weeks after implantation and whether the concentration is higher than the minimal inhibition concentration (MIC) previously determined for pathogens that are responsible for most periprosthetic infections. Methods We removed 14 spacers used in two-stage septic revisions of infected hip prostheses 6 weeks after the primary implantations and determined the concentration of the antibiotics in the membrane formed between the spacer and the neighboring bone on the acetabular and the femoral sides. In seven cases Copal cement with gentamicin and clindamycin were used, and in seven other cases vancomycin was added to the Copal cement. Concentrations of the spacer antibiotics in the neighboring tissue were determined by tandem mass spectroscopy. Results All three antibiotics were detected in concentrations higher than their MIC. There were no differences between the groups regardless whether vancomycin was added to the cement, or whether the cement was applied with the acetabular cup spacer or with the stem spacer. Conclusions We concluded that, using the spacer technique described in this study, 6 weeks after spacer implantation, the concentrations of antibiotic are sufficient to treat a periprosthetic infection.

show abstract

“…This approach has been shown to prevent resistance, as two concurrent mutations are required for bacterial survival when two antibiotics of different classes are each maintained at levels above their minimum inhibitory concentrations (Eliopoulos and Eliopoulos, 1988;Fantin and Carbon, 1992;Gould, 1999;Zhao and Drlica, 2001). The combination of gentamicin sulphate and clindamycin hydrochloride has been shown to have an antimicrobial effect on more than 90 % of bacteria common to infected arthroplasties (Kuhn, 2000) and is more effective in preventing biofilm formation than bone cements with gentamicin alone (Neut et al, 2005). The combination can be expected to have activity against gram-positive bacteria (e.g.…”

Section: Discussionmentioning

confidence: 99%

A biodegradable antibiotic-impregnated scaffold to prevent osteomyelitis in a contaminated in vivo bone defect model

McLaren

White²,

Cox³

et al. 2014

eCM

View full text Add to dashboard Cite

Open fractures are at risk of serious infection and, if infected, require several surgical interventions and courses of systemic antibiotics. We investigated a new injectable formulation that simultaneously hardens in vivo to form a porous scaffold for bone repair and delivers antibiotics at high concentrations to the local site of infection. Duration of antimicrobial activity against Staphylococcus aureus was determined using the serial plate transfer test. Ultimate compressive strength and porosity of the material was measured with and without antibiotics. The material was evaluated in vivo in an ovine medial femoral condyle defect model contaminated with S. aureus. Sheep were sacrificed at either 2 or 13 weeks and the defect and surrounding bone assessed using micro-computed tomography and histology. Antimicrobial activity in vitro persisted for 19-21 days. Sheep with antibiotic-free material and bacteria became infected, while those with antibiotic-containing material and bacteria did not. Similarly, new bone growth was seen in uninoculated animals with plain polymer, and in those with antibiotic polymer with bacteria, but not in sheep with plain polymer and bacteria. The antibiotic-impregnated scaffolds were effective in preventing S. aureus infections whilst supporting bone growth and repair. If translated into clinical practice, this approach might reduce the need for systemic antibiotics.

show abstract

Gentamicin‐loaded bone cement with clindamycin or fusidic acid added: Biofilm formation and antibiotic release

Cited by 58 publications

References 23 publications

Anti-sessile bacterial and cytocompatibility properties of CHX-loaded nanohydroxyapatite

Anti-sessile bacterial and cytocompatibility properties of CHX-loaded nanohydroxyapatite

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

A biodegradable antibiotic-impregnated scaffold to prevent osteomyelitis in a contaminated in vivo bone defect model

Contact Info

Product

Resources

About