In vitro release of antibiotics from commercial PMMA beads and articulating hip spacers.
The efficacy and benefits of high-dose antibiotic cement spacers compared with beads in the treatment of an infected prosthesis have been shown. However, in clinical practice, commercial, low-dose antibiotic bone cement is often used. This study investigated the in vitro antibiotic release of hip spacers made from Refobacin-Palacos-R or Antibiotic-Simplex-P cement compared with Septopal beads. Antibiotic concentrations were measured during 6 weeks. All carriers showed a burst release, but spacers showed little additional release after the first week. Cumulative release was 27.5 +/- 2.3 mg for Palacos, 23.8 +/- 0.2 mg for Simplex, and 188.3 +/- 9.3 mg for Septopal (P < .001). Despite the efficacy of high-dose antibiotic bone cement spacers, we believe one should be cautious toward using low-dose antibiotic bone cement for spacers because this could result in an unsuccessful eradication of infection.
Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
Dirk Jan F
DJ
Moojen
Bram
B
Hentenaar
H
H
Charles Vogely
Abraham J
AJ
Verbout
René M
RM
Castelein
Wouter J A
WJ
Dhert
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D001424:Bacterial Infections / Q000517:prevention & control; D001843:Bone Cements; D004305:Dose-Response Relationship, Drug; D016503:Drug Delivery Systems; D005839:Gentamicins / Q000008:administration & dosage* / Q000627:therapeutic use; D006622:Hip Prosthesis; D006801:Humans; D008863:Microspheres; D019904:Polymethyl Methacrylate; D016459:Prosthesis-Related Infections / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D005839:Gentamicins; D019904:Polymethyl Methacrylate