[Elution kinetics and antimicrobial effects of gentamicin- and clindamycin-loaded bone cements in vitro].
OBJECTIVE
In arthroplasty and particulary in revision surgery antibiotic-loaded bone cements are applied. The purpose of the current study was to analyse the kinetics of antibiotic release and antimicrobial effects of the gentamicin- and clindamycin-loaded bone cement Versabond.


METHODS
Test cylinders of bone cements, containing gentamicin and clindamycin in different concentrations, were investigated in vitro with regards to the kinetics of antibiotic release by applying static and continuous elution methods. Antimicrobial effects of antibiotic-loaded bone cement were tested in an infection model with different strains of Staphylococcus aureus and Staphylococcus epidermidis and live/dead dye plus fluorescence microscopy. For the surface analysis of antibiotic-loaded test cylinders contaminated with Staphylococcus epidermidis, scanning electron microscopy was used.


RESULTS
The measurement of static and continuous elution revealed initially higher rates of gentamicin release in comparison with clindamycin. The gentamicin amount decreased within 24 h, whereas clindamycin-loaded test cylinders showed a prolonged release. After 24 h exclusive avital bacteria on antibiotic-loaded cement cylinders were seen, after 72 h on gentamicin-loaded cement bacterial growth was again detected. Application of antibiotics in bone cement revealed an inhomogeneous surface of the bone cement cylinder.


CONCLUSIONS
On application of clindamycin in bone cement the features of increased antibiotic uptake and antimicrobial effect compared with gentamicin-loaded bone cement are observed.
Schiefer
U R
UR
Klinik für Unfallchirurgie, Universitätsklinikum Giessen-Marburg, Giessen.
Heiss
C
C
Dingeldein
E
E
Wenisch
S
S
Schnettler
R
R
Kilian
O
O
D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000494:pharmacology; D001843:Bone Cements / Q000493:pharmacokinetics*; D001842:Bone and Bones / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D002981:Clindamycin / Q000493:pharmacokinetics* / Q000494:pharmacology; D004058:Diffusion; D004305:Dose-Response Relationship, Drug; D004343:Drug Implants; D005839:Gentamicins / Q000493:pharmacokinetics* / Q000494:pharmacology; D006801:Humans; D066298:In Vitro Techniques; D008657:Metabolic Clearance Rate / Q000502:physiology; D008826:Microbial Sensitivity Tests; D008855:Microscopy, Electron, Scanning; D008856:Microscopy, Fluorescence; D019904:Polymethyl Methacrylate / Q000493:pharmacokinetics* / Q000494:pharmacology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D013211:Staphylococcus aureus / Q000187:drug effects*; D013212:Staphylococcus epidermidis / Q000187:drug effects*; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D004343:Drug Implants; D005839:Gentamicins; C529141:versabond; D002981:Clindamycin; D019904:Polymethyl Methacrylate