title: Pre-packing of cost effective antibiotic cement beads for the treatment of traumatic osteomyelitis in the developing world - an in-vitro study based in Cambodia.
abstract: The developing world often lacks the resources to effectively treat the most serious injuries including osteomyelitis following open fractures or surgical fracture treatment. Antibiotic cement beads are a widely accepted method of delivering antibiotics locally to the infected area following trauma. This study is based in Cambodia, a low income country struggling to recover from a recent genocide. The study aims to test the effectiveness of locally made antibiotic beads and analyse their effectiveness after being gas sterilised, packaged and kept in storage Different antibiotic beads were manufactured locally using bone cement and tested against MRSA bacteria grown from a case of osteomyelitis. Each antibiotic was tested before and after a process of gas sterilisation as well as later being tested after storage in packaging up to 42 days. The gentamicin, vancomycin, amikacin and ceftriaxone beads all inhibited growth of the MRSA on the TSB and agar plates, both before and after gas sterilisation. All four antibiotics continued to show similar zones of inhibition after 42 days of storage. The results show significant promise to produce beads with locally obtainable ingredients in an austere environment and improve cost effectiveness by storing them in a sterilised condition.
authors.affiliation: Childrens Surgical Centre, Cambodia. Electronic address: saqibnoor@doctors.org.uk.
authors.forename: S
authors.initials: S
authors.lastname: Noor
authors.affiliation: Childrens Surgical Centre, Cambodia.
authors.forename: A
authors.initials: A
authors.lastname: Gilson
authors.affiliation: Childrens Surgical Centre, Cambodia.
authors.forename: K
authors.initials: K
authors.lastname: Kennedy
authors.affiliation: Childrens Surgical Centre, Cambodia.
authors.forename: A
authors.initials: A
authors.lastname: Swanson
authors.affiliation: Childrens Surgical Centre, Cambodia.
authors.forename: V
authors.initials: V
authors.lastname: Vanny
authors.affiliation: Childrens Surgical Centre, Cambodia.
authors.forename: K
authors.initials: K
authors.lastname: Mony
authors.affiliation: Childrens Surgical Centre, Cambodia.
authors.forename: T
authors.initials: T
authors.lastname: Chaudhry
authors.affiliation: Childrens Surgical Centre, Cambodia.
authors.forename: J
authors.initials: J
authors.lastname: Gollogly
mesh_terms: D000583:Amikacin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics / Q000493:pharmacokinetics; D001843:Bone Cements; D002160:Cambodia; D002443:Ceftriaxone / Q000008:administration & dosage; D003362:Cost-Benefit Analysis; D003692:Delayed-Action Preparations / Q000008:administration & dosage* / Q000191:economics / Q000493:pharmacokinetics; D016503:Drug Delivery Systems; D004355:Drug Stability; D005597:Fractures, Open / Q000150:complications / Q000191:economics / Q000382:microbiology*; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D008863:Microspheres; D010019:Osteomyelitis / Q000188:drug therapy* / Q000191:economics / Q000517:prevention & control; D019904:Polymethyl Methacrylate; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D003692:Delayed-Action Preparations; D005839:Gentamicins; D014640:Vancomycin; D002443:Ceftriaxone; D000583:Amikacin; D019904:Polymethyl Methacrylate
keywords: Antibiotics; Cement beads; Chronic; Developing world; Infection; Osteomyelitis; Trauma