Treatment of osteomyelitis by antibiotic impregnated porous hydroxyapatite block.
A novel drug delivery system was developed for osteomyelitis using porous hydroxyapatite blocks (HA-b) that were impregnated with antibiotics by a centrifuge method. For the experimental study, a 10 mm3 HA-b was placed in a container, mixed with an antibiotic solution and centrifuged at 1500 rpm for 15 min for the purpose of impregnating antibiotics into the pores. The slow release activity of antibiotic (Arbekacin sulfate [1-N-(S)-4 amino-2-hydroxybutyryl dibekacin]) from the HA-b was tested. An evaluation was made of the slow-releasing capabilities of the ABK from HA-b which was still maintained at 0.5 microgram/ml within 21 exchanges of PBS after 42 days. Consequently, seven patients with osteomyelitis, including one with tuberculosis and two with infected hip arthroplasty, have been treated. On a follow-up study, all of the foci had completely healed by the end of the follow-up period without complications. This new method is simple and can be performed safety as a one-stage operation.
Itokazu
M
M
Department of Orthopaedic Surgery, Gifu University School of Medicine, Japan.
Matsunaga
T
T
Kumazawa
S
S
Oka
M
M
D000293:Adolescent; D000421:Alcaligenes; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003982:Dibekacin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016503:Drug Delivery Systems; D017886:Durapatite; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000188:drug therapy; D013212:Staphylococcus epidermidis; D014376:Tuberculosis / Q000188:drug therapy