Release of vancomycin and tobramycin from polymethylmethacrylate cements impregnated with calcium polyphosphate hydrogel

Abstract

The influence of calcium polyphosphate (CPP) gel incorporation on the release of vancomycin and tobramycin from polymethyl methacrylate (PMMA) cement (Simplex P, SP) has been studied. Adding 10% CPP gel to SP led to a much lower burst release of vancomycin and considerably extended release of both vancomycin and tobramycin up to 24 weeks. Antibiotics released from this new material retain their bactericidal activity for up to 15 weeks. The improvement in the antibiotic release is mainly due to the molecular interactions of antibiotics with embedded CPP polyphosphate chains as confirmed by Raman spectroscopy analysis. The inclusion of CPP hydrogel also increased the SP surface roughness and pore sizes, leading to a higher release rate of antibiotics. The new material is biocompatible and has similar handling properties and mechanical strength as compared to SP cements. We believe that incorporating CPP gel provides a better and usable drug carrier for PMMA cement. © 2017 The Authors Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2827-2840, 2018.

Gallium Porphyrin and Gallium Nitrate Reduce the High Vancomycin Tolerance of MRSA Biofilms by Promoting Extracellular DNA-Dependent Biofilm Dispersion

“…14−16 In vivo, the high concentrations of vancomycin required for biofilm treatment such as 160 or even 1600 mg/L are difficult to achieve in plasma (guidelines recommend a peak serum concentration of 25−40 mg/L vancomycin); 17 therefore, the high concentrations of vancomycin therapy have an unsurmountable obstacle by intravenous administration and are generally administered locally by a two-stage surgery in present clinical settings, for example, the antibiotic-loaded bone cement poly(methyl methacrylate) (PMMA) spacers. 18 Such treatments require immediate lengthy hospitalizations and expensive medical insurance payments. 19,20 Tolerance is defined as the ability of bacteria to temporarily survive in the presence of high concentrations of antimicrobial agents, independent of minimum inhibitory concentration (MIC).…”

“…Vancomycin has been shown to penetrate biofilms, and high concentrations of vancomycin (160 mg/L) kill the majority of biofilm-associated S. aureus within 24 h of treatment in virto . However, vancomycin treatment of biofilms is inefficient due to the high vancomycin tolerance of the bacteria remaining in the biofilm-matrix remnants after treatment. − In vivo, the high concentrations of vancomycin required for biofilm treatment such as 160 or even 1600 mg/L are difficult to achieve in plasma (guidelines recommend a peak serum concentration of 25–40 mg/L vancomycin); therefore, the high concentrations of vancomycin therapy have an unsurmountable obstacle by intravenous administration and are generally administered locally by a two-stage surgery in present clinical settings, for example, the antibiotic-loaded bone cement poly­(methyl methacrylate) (PMMA) spacers . Such treatments require immediate lengthy hospitalizations and expensive medical insurance payments. , …”

A slow and sustained release of methotrexate (MTX) from a new polymeric dicalcium phosphate dehydrate cement (P-DCPD)

“…P-DCPD represents a new bone void filler with significant advantages, including strong mechanically strength, 26 excellent cohesion, 24 as well as a mean of sustained drug delivery 27,28 because of its unique ionic binding and intrinsic entanglement of polyphosphate chains with embedded drugs. 29 The handling properties of P-DCPD is similar to PMMA cement and other commercially available CPCs. P-DCPD is mainly composed of calcium and phosphor and contains no cross-linkers or other additives.…”

Progress of antibiotic-loaded bone cement in joint arthroplasty

“…[ 48 – 50 ] Calcium polyphosphate, an analog of bone tissue, extended the elution time, with a significant decrease in the initial elution and maintenance of bioactivity. [ 51 ] When coated on PMMA in combination with alginate-chitosan nanoparticles, vancomycin prolonged drug elution for 60 days. [ 52 ] Rifampin-filled β-cyclodextrin particles achieved a longer effect time but no longer met the weight-bearing standard.…”