title: Elution of High Dose Amphotericin B Deoxycholate From Polymethylmethacrylate.
abstract: Fungal periprosthetic joint infections are rare, devastating complications of arthroplasty. There is conflicting evidence as to the efficacy of amphotericin B elution from cement spacers. The purpose of this study was to determine whether concentrations of amphotericin B released from bone cement over time would be efficacious in treating a periprosthetic infection. A continuous flow chamber was used to evaluate the in vitro release of amphotericin from cement beads containing 7.5% amphotericin. Following polymerization, 3.3% of the initially loaded amphotericin B was detected. The peak mean concentration eluted from the bone cement was 0.33 μg/mL at 8 hours. The AUC0-24 was 2.79 μg/mL/h; 0.20% of the amphotericin B was released. In conclusion, amphotericin B is released from bone cement at a clinically useful concentration.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Houdek
authors.affiliation: Department of Laboratory Medicine and Pathology, Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Kerryl E
authors.initials: KE
authors.lastname: Greenwood-Quaintance
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Morrey
authors.affiliation: Department of Laboratory Medicine and Pathology, Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Robin
authors.initials: R
authors.lastname: Patel
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Arlen D
authors.initials: AD
authors.lastname: Hanssen
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology*; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology*; D001843:Bone Cements / Q000493:pharmacokinetics / Q000494:pharmacology*; D003840:Deoxycholic Acid / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology*; D004338:Drug Combinations; D008863:Microspheres; D009181:Mycoses / Q000188:drug therapy; D019904:Polymethyl Methacrylate / Q000493:pharmacokinetics / Q000494:pharmacology*; D016459:Prosthesis-Related Infections / Q000188:drug therapy
chemical_list: D000935:Antifungal Agents; D001843:Bone Cements; D004338:Drug Combinations; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination; D019904:Polymethyl Methacrylate
keywords: amphotericin; cement spacer; drug elution; fungal infection; prosthetic joint infection