title: A biodegradable antibiotic delivery system based on poly-(trimethylene carbonate) for the treatment of osteomyelitis.
abstract: OBJECTIVE
  Many investigations on biodegradable materials acting as an antibiotic carrier for local drug delivery are based on poly(lactide). However, the use of poly(lactide) implants in bone has been disputed because of poor bone regeneration at the site of implantation. Poly(trimethylene carbonate) (PTMC) is an enzymatically degradable polymer that does not produce acidic degradation products. We explored the suitability of PTMC as an antibiotic releasing polymer for the local treatment of osteomyelitis.
  
  
  METHODS
  This study addressed 2 separate attributes of PTMC: (1) the release kinetics of gentamicin-loaded PTMC and (2) its behavior in inhibiting biofilm formation. Both of these characteristics were compared with those of commercially available gentamicin-loaded poly(methylmethacrylate) (PMMA) beads, which are commonly used in the local treatment of osteomyelitis.
  
  
  RESULTS
  In a lipase solution that mimics the in vivo situation, PTMC discs with gentamicin incorporated were degraded by surface erosion and released 60% of the gentamicin within 14 days. This is similar to the gentamicin release from clinically used PMMA beads. Moreover, biofilm formation by Staphylococcus aureus was inhibited by approximately 80% over at least 14 days in the presence of gentamicin-loaded PTMC discs. This is similar to the effect of gentamicin-loaded PMMA beads. In the absence of the lipase, surface erosion of PTMC discs did not occur and gentamicin release and biofilm inhibition were limited.
  
  
  CONCLUSIONS
  Since gentamicin-loaded PTMC discs show antibiotic release characteristics and biofilm inhibition characteristics similar to those of gentamicin-loaded PMMA beads, PTMC appears to be a promising biodegradable carrier in the local treatment of osteomyelitis.
authors.affiliation: Department of Biomedical Engineering, University Medical Center Groningen and University of Groningen, Groningen, the Netherlands. d.neut@med.umcg.nl
authors.forename: Daniëlle
authors.initials: D
authors.lastname: Neut
authors.forename: Otto S
authors.initials: OS
authors.lastname: Kluin
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Crielaard
authors.forename: Henny C
authors.initials: HC
authors.lastname: van der Mei
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Busscher
authors.forename: Dirk W
authors.initials: DW
authors.lastname: Grijpma
mesh_terms: D020341:Absorbable Implants; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D018441:Biofilms; D001843:Bone Cements; D004146:Dioxanes / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004337:Drug Carriers; D005839:Gentamicins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D020366:Methylmethacrylate / Q000008:administration & dosage / Q000493:pharmacokinetics; D010019:Osteomyelitis / Q000188:drug therapy*; D011108:Polymers / Q000008:administration & dosage* / Q000493:pharmacokinetics; D016459:Prosthesis-Related Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D004146:Dioxanes; D004337:Drug Carriers; D005839:Gentamicins; D011108:Polymers; D020366:Methylmethacrylate; C059299:polytrimethylene carbonate