Liquid antibiotics in bone cement: an effective way to improve the efficiency of antibiotic release in antibiotic loaded bone cement.
2014
Objectives The objective of this study was to compare the elution characteristics,
antimicrobial activity and mechanical properties of antibiotic-loaded
bone cement (ALBC) loaded with powdered antibiotic, powdered antibiotic
with inert filler (xylitol), or liquid antibiotic, particularly focusing
on vancomycin and amphotericin B. Methods Cement specimens loaded with 2 g of vancomycin or amphotericin
B powder (powder group), 2 g of antibiotic powder and 2 g of xylitol
(xylitol group) or 12 ml of antibiotic solution containing 2 g of
antibiotic (liquid group) were tested. Results Vancomycin elution was enhanced by 234% in the liquid group and
by 12% in the xylitol group compared with the powder group. Amphotericin
B elution was enhanced by 265% in the liquid group and by 65% in
the xylitol group compared with the powder group. Based on the disk-diffusion
assay, the eluate samples of vancomycin-loaded ALBC of the liquid group
exhibited a significantly larger inhibitory zone than samples of
the powder or the xylitol group. Regarding the ALBCs loaded with
amphotericin B, only the eluate samples of the liquid group exhibited
a clear inhibitory zone, which was not observed in either the xylitol
or the powder groups. The ultimate compressive strength was significantly
reduced in specimens containing liquid antibiotics. Conclusions Adding vancomycin or amphotericin B antibiotic powder in distilled
water before mixing with bone cement can significantly improve the
efficiency of antibiotic release than can loading ALBC with the
same dose of antibiotic powder. This simple and effective method for
preparation of ALBCs can significantly improve the efficiency of
antibiotic release in ALBCs. Cite this article: Bone Joint Res 2014;3:246–51.
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