Vancomycin and meropenem in acrylic cement: elution kinetics of in vitro bactericidal action

Andollina, Agnese; Bertoni, Franco; Zolezzi, Carola; Trentani, F; Trentani, P; Borrelli, Anna; Tigani, Domenico

doi:10.1007/s12306-007-0025-0

Cited by 25 publications

(26 citation statements)

References 14 publications

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“…Similar release profiles have been reported showing less than 5% of vancomycin was released from bone cement after 4-5 weeks in vitro [4,7]. The inclusion of sodium chloride in bone cement beads loaded with 2.5% vancomycin resulted in a concentration-dependent increase in the release rate of drug.…”

Section: Resultssupporting

confidence: 84%

“…PMMA sets to a hard material that is impervious to water so that all drugs, studied to date, release very slowly from bone cement. Typically, less than 10% of the loaded drug is released after 6 weeks in aqueous environments [4,7,17,42,43]. Furthermore, most of the drug is eluted from the implant in the first week so that subsequent drug release levels may fall below the MIC with the added problem of the development of drug resistance.…”

Section: Introductionmentioning

confidence: 99%

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The use of bone cement for the localized, controlled release of the antibiotics vancomycin, linezolid, or fusidic acid: effect of additives on drug release rates and mechanical strength

Jackson

Leung

Duncan

et al. 2011

Drug Deliv. and Transl. Res.

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Bone cement containing antibiotics is commonly used to treat orthopedic related infections. However, effective treatment (especially of resistant bacteria, methacillin-resistant Staphylococcus aureus (MRSA)) is compromised by very low levels of drug release so that typically less than 10% of loaded drug is released over a 6-week period. The objective of this study was to investigate the effect of incorporation of water soluble excipients (polyethylene glycol, sodium chloride, or dextran) into antibiotic-loaded cement on mechanical strength and drug release properties. Poly(methyl methylacrylate) cement implants containing various amounts of drug (vancomycin, linezolid or fusidic acid (all MRSA active)) and excipients were cast in the form of beads or films and characterized using differential scanning calorimetry. Mechanical strength as assessed by Young's modulus was determined by thermo-mechanical analysis. Drug release was measured by incubation in phosphate buffered saline with analysis by HPLC methods. The inclusion of sodium chloride up to 20% w/w caused only minor reductions in Young's modulus. Vancomycin and linezolid released very slowly from unmodified bone cement beads (less than 3% released by 4 weeks) whereas fusidic acid released more quickly (approximately 8% released by 4 weeks). The inclusion of sodium chloride or dextran in bone cement resulted in major increases in the release rate of vancomycin, linezolid and fusidic acid. These studies support the inclusion of sodium chloride and dextran in bone cement to increase the release rate of vancomycin, linezolid, or fusidic acid without compromising the mechanical strength of the composite material.

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Section: Resultssupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The use of bone cement for the localized, controlled release of the antibiotics vancomycin, linezolid, or fusidic acid: effect of additives on drug release rates and mechanical strength

Jackson

Leung

Duncan

et al. 2011

Drug Deliv. and Transl. Res.

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show abstract

“…PMMA is particularly interesting for this application as it is used extensively in orthopedic settings as a drug delivery vehicle for antibiotics because of its high biocompatibility and ease of manipulation . PMMA is a hydrophobic polymer; therefore, only a small percentage of the encapsulated drug is released from monolithic forms with low surface area to volume ratios . The release profiles may be modulated by the inclusion of water‐soluble excipients or increasing the surface area by using electrospinning .…”

Section: Resultsmentioning

confidence: 99%

Development of a nanofibrous wound dressing with an antifibrogenic properties in vitro and in vivo model

Poormasjedi‐Meibod

Pakyari

Jackson

et al. 2016

J Biomedical Materials Res

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Dermal fibrosis, characterized by excessive extracellular matrix (ECM), is a pathological condition with limited effective therapeutic modalities. Lack of an antiscarring dressing further impedes the preventive measures for this condition. Here, we develop a new antiscarring dressing and investigate its potential as a slow-releasing vehicle for kynurenic acid (KynA), an antifibrotic agent. KynA was incorporated into polymethyl methacrylate (PMMA) nanofibers, containing increasing concentration of polyethylene glycol (PEG). Fibre morphology, water absorption capacity, surface hydrophilicity, in vitro drug release profile, and in vivo antifibrotic effects were investigated. Increasing concentrations of PEG (1-20%) significantly increased surface hydrophilicity, water absorption capacity, and drug release. Based on the obtained release profiles, PMMA + 10% PEG was the preferred formulation for sustained KynA release up to 120 hours. In vitro studies confirmed the preservation of KynA antifibrotic properties during electrospinning, indicated by fibroblasts proliferation suppression and ECM expression modulation. In vivo application of KynA-incorporated films significantly inhibited collagen (23.89 ± 4.79 vs. 6.99 ± 0.41, collagen-I/β-actin mRNA expression, control vs. treated) and fibronectin expression (7.18 ± 1.09 vs. 2.31 ± 0.05, fibronectin/β-actin mRNA expression, control vs. treated) and enhanced the production of an ECM-degrading enzyme (2.03 ± 0.88 vs. 11.88 ± 1.16 MMP-1/β-actin mRNA expression, control vs. treated). The fabricated KynA-incorporated films can be exploited as antifibrotic wound dressings. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2334-2344, 2016.

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“…The authors observed a 28-day elution rate that was remarkably higher than those reported by a previous study that evaluated vancomycin and meropenem after a similar observation time. 23 However, note that any comparison of their results with previous studies is difficult because of some methodological differences. Indeed, different factors, such as the cement characteristics, contact/exchange surface, compound conditions, and antibiotic type and amount, have been previously thought to determine the antibiotic release from the acrylic cement.…”

Section: Discussionmentioning

confidence: 99%

Drug Elution From High-Dose Antibiotic-Loaded Acrylic Cement: A Comparative, In Vitro Study

Gasparini¹,

Gori²,

Calonego³

et al. 2014

Orthopedics

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High-dose antibiotic-loaded acrylic cement (ALAC) is used for managing peri-prosthetic joint infections (PJIs). The marked increase in resistant high-virulence bacteria is drawing the attention of physicians toward alternative antimicrobial formulations loaded into acrylic bone cement. The aim of this in vitro study was to determine the elution kinetics of 14 different high-dose ALACs. All ALAC samples showed a burst release of antibiotics in the first hour, progressively decreasing over time, and elution curves strictly adhered to a nonlinear regression analysis formula. Among aminoglycosides, commonly seen as the most appropriate antibiotics to be loaded into the bone cement, the highest elution rate was that of tobramycin. Among the glycopeptides, a class of antibiotics that should be considered to treat PJIs because of the prevalence of aminoglycoside resistance, vancomycin showed better elution than teicoplanin. Clindamycin, which can be associated with aminoglycosides to prepare ALACs and represents a useful option against the most common pathogens responsible for PJIs, showed the highest absolute and relative elutions among all the tested formulations. A noticeable elution was also detected for colistin, an antibiotic of last resort for treating multidrug-resistant bacteria. The current study demonstrates theoretical advantages in the preparation of ALAC for some antibiotics not routinely used in the clinical setting for PJIs. The use of these antibiotics based on the infecting bacteria sensitivity may represent a useful option for physicians to eradicate PJIs. In vivo testing should be considered in the future to confirm the results of this study.

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Vancomycin and meropenem in acrylic cement: elution kinetics of in vitro bactericidal action

Cited by 25 publications

References 14 publications

The use of bone cement for the localized, controlled release of the antibiotics vancomycin, linezolid, or fusidic acid: effect of additives on drug release rates and mechanical strength

The use of bone cement for the localized, controlled release of the antibiotics vancomycin, linezolid, or fusidic acid: effect of additives on drug release rates and mechanical strength

Development of a nanofibrous wound dressing with an antifibrogenic properties in vitro and in vivo model

Drug Elution From High-Dose Antibiotic-Loaded Acrylic Cement: A Comparative, In Vitro Study

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