title: Microbiological and pharmacological tests on new antibiotic-loaded PMMA-based composites for the treatment of osteomyelitis.
abstract: Local antibiotic diffusion in rabbit femurs from two new PMMA-based and nail-shaped composites, enriched with β-tricalcium phosphate (P-TCP) and BaSO(4) or only with BaSO(4) (P-BaSO(4) ), and soaked in a solution of gentamicin (G) and vancomycin (V) was studied. Nails were implanted into the intramedullary cavity of healthy and osteomyelitic femurs to study the resolution of infection and to quantify the antibiotic penetration into bone by microbiological, pharmacological, and histological tests. A significant progression of osteomyelitis was recorded 7 weeks after MRSA inoculation, whereas no bacteria were found in animals treated with antibiotic-loaded nails as confirmed by microbiology and histology (Smeltzer score). The release of both antibiotics from composites was high and prompt both in healthy and infected bone; the amount of V was higher than that of G in all bone samples. Antibiotics of both composites were still present in bone 3 weeks after nail implantation. The P-BaSO4 composite released a lower amount of antibiotics than did P-TCP. The G-V combination in vivo exerted a synergistic bactericidal effect, which was confirmed by microbiological, histological, and clinical results (no infection). These new porous PMMA composites, soaked in G-V solution in the operating room, might be an effective and useful drug delivery system for osteomyelitis treatment.
authors: Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopaedic Institute IRCCS, via di Barbiano 1/10, 40136, Bologna, Italy. gianluca.giavaresi@ior.it
authors: Gianluca
authors: G
authors: Giavaresi
authors: Elisa
authors: E
authors: Bertazzoni Minelli
authors: Maria
authors: M
authors: Sartori
authors: Anna
authors: A
authors: Benini
authors: Tommaso
authors: T
authors: Della Bora
authors: Vittorio
authors: V
authors: Sambri
authors: Paolo
authors: P
authors: Gaibani
authors: Veronica
authors: V
authors: Borsari
authors: Francesca
authors: F
authors: Salamanna
authors: Lucia
authors: L
authors: Martini
authors: Nicolò
authors: N
authors: Nicoli Aldini
authors: Milena
authors: M
authors: Fini
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001858:Bone Nails; D004058:Diffusion; D005839:Gentamicins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008297:Male; D010019:Osteomyelitis / Q000188:drug therapy*; D019904:Polymethyl Methacrylate; D011817:Rabbits; D014640:Vancomycin / Q000008:administration & dosage* / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014640:Vancomycin; D019904:Polymethyl Methacrylate