Treatment of osteomyelitis with antibiotic-soaked porous glass ceramic.
We have developed a new drug delivery system using porous apatite-wollastonite glass ceramic (A-W GC) to treat osteomyelitis. A-W GC (porosity, 70% and 20% to 30%), or porous hydroxyapatite (HA) blocks (porosity 35% to 48%) used as controls, were soaked in mixtures of two antibiotics, isepamicin sulphate (ISP) and cefmetazole (CMZ) under high vacuum. We evaluated the release concentrations of the antibiotics from the blocks. The bactericidal concentration of ISP from A-W GC was maintained for more than 42 days, but that from HA decreased to below the detection limit after 28 days. The concentrations of CMZ from both materials were lower than those of ISP. An in vivo study using rabbit femora showed that an osseous concentration of ISP was maintained at eight weeks after implantation. Osteoconduction of the A-W GC block was good. Four patients with infected hip arthroplasties and one with osteomyelitis of the tibia have been treated with the new delivery system with excellent results.
Kawanabe
K
K
Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.
Okada
Y
Y
Matsusue
Y
Y
Iida
H
H
Nakamura
T
T
D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001031:Apatites / Q000737:chemistry; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D017610:Calcium Compounds / Q000737:chemistry; D015311:Cefmetazole / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002513:Cephamycins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002516:Ceramics / Q000737:chemistry; D016503:Drug Delivery Systems; D004343:Drug Implants; D004359:Drug Therapy, Combination / Q000008:administration & dosage* / Q000493:pharmacokinetics; D017886:Durapatite / Q000737:chemistry; D005260:Female; D005269:Femur / Q000378:metabolism / Q000601:surgery; D005839:Gentamicins / Q000008:administration & dosage / Q000493:pharmacokinetics; D005898:Glass / Q000737:chemistry; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000378:metabolism; D010865:Pilot Projects; D016062:Porosity; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D011817:Rabbits; D017640:Silicates / Q000737:chemistry; D013977:Tibia / Q000601:surgery; D013997:Time Factors
D000900:Anti-Bacterial Agents; D001031:Apatites; D017610:Calcium Compounds; D002513:Cephamycins; D004343:Drug Implants; D005839:Gentamicins; D017640:Silicates; D015311:Cefmetazole; D017886:Durapatite; C016927:isepamicin; C031293:calcium silicate