Local Antibiotic Delivery with Bovine Cancellous Chips

2010 ◽  
Vol 26 (4) ◽  
pp. 491-506 ◽  
Author(s):  
Christine S. Lewis ◽  
Jordan Katz ◽  
Maribel I. Baker ◽  
Peter R. Supronowicz ◽  
Elise Gill ◽  
...  
Keyword(s):  
Standard Of Care ◽  
Secondary Surgery ◽  
Primary Osteoblast ◽  
Systemic Antibiotic Therapy ◽  
Bone Void Filler ◽  
Orthopedic Applications ◽  
Local Antibiotic ◽  
Bone Void ◽  
Antibiotic Delivery

Infected bone defects and osteomyelitis are encountered frequently in trauma cases. Currently, the standard of care for osteomyelitis cases is prolonged systemic antibiotic therapy and implantation of antibiotic carrier beads. However, this method requires a secondary surgery to remove the beads after the infection has cleared. In the present study a common bone void filler was investigated for its ability to be infused with an antibiotic. This study demonstrates that the xenograft material tested can be loaded with gentamicin and release clinically relevant levels of the drug for at least 14 days in vitro allowing for the inhibition of bacterial growth on the graft. This study also demonstrates that the levels of gentamicin released did not have an adverse effect on primary osteoblast cell proliferation or ability to generate alkaline phosphatase. This bone void filler may represent a viable alternative to current methods of local antibiotic delivery in orthopedic applications.

Heparin-mediated antibiotic delivery from an electrochemically-aligned collagen sheet

2021 ◽  
pp. 1-12
Author(s):  
Olivia T. Cheng ◽  
Andrew P. Stein ◽  
Eric Babajanian ◽  
Kathryn R. Hoppe ◽  
Shawn Li ◽  
...  
Keyword(s):  
High Performance ◽  
Inhibitory Concentration ◽  
Medical Implants ◽  
Implantable Medical Devices ◽  
Antibiotic Solution ◽  
Inhibition Zones ◽  
Antibiotic Release ◽  
Local Antibiotic ◽  
Antibiotic Delivery

BACKGROUND: Implantable medical devices and hardware are prolific in medicine, but hardware associated infections remain a major issue. OBJECTIVE: To develop and evaluate a novel, biologic antimicrobial coating for medical implants. METHODS: Electrochemically compacted collagen sheets with and without crosslinked heparin were synthesized per protocol developed by our group. Sheets were incubated in antibiotic solution (gentamicin or moxifloxacin) overnight, and in vitro activity was assessed with five-day diffusion assays against Pseudomonas aeruginosa. Antibiotic release overtime from gentamicin infused sheets was determined using in vitro elution and high performance liquid chromatography (HPLC). RESULTS: Collagen-heparin-antibiotic sheets demonstrated larger growth inhibition zones against P. aeruginosa compared to collagen-antibiotic alone sheets. This activity persisted for five days and was not impacted by rinsing sheets prior to evaluation. Rinsed collagen-antibiotic sheets did not show any inhibition zones. Elution of gentamicin from collagen-heparin-gentamicin sheets was slow and remained above the minimal inhibitory concentration for gentamicin sensitive organisms for 29 days. Conversely, collagen-gentamicin sheets eluted their antibiotic payload within 24 hours. Overall, heparin associated sheets demonstrated larger inhibition zones against P. aeruginosa and prolonged elution profile via HPLC. CONCLUSION: We developed a novel, local antibiotic delivery system that could be used to coat medical implants/hardware in the future and reduce post-operative infections.

scholarly journals Evaluation of Antibiotic-Releasing Triphasic Bone Void Filler In-Vitro

2018 ◽  
Vol 9 (4) ◽  
pp. 55 ◽  
Author(s):  
Michael Harris ◽  
Hamza Ahmed ◽  
Leslie Pace ◽  
Jon Minter ◽  
Michael Neel ◽  
...  
Keyword(s):  
Tricalcium Phosphate ◽  
Calcium Sulfate ◽  
Minimal Effect ◽  
Time Points ◽  
Dissolution Study ◽  
Infection Treatment ◽  
Bone Void Filler ◽  
Bone Void

Bone void fillers (BVFs) containing calcium sulfate, tricalcium phosphate (TCP), and hydroxyapatite can be loaded with antibiotics for infection treatment or prevention under surgeon-directed use. The aim of this study was to characterize the handling and elution properties of a triphasic BVF loaded with common antibiotics. BVF was mixed with vancomycin and/or tobramycin to form pellets, and the set time was recorded. A partial refreshment elution study was conducted with time points at 4, 8, and 24 h, as well as 2, 7, 14, 28, and 42 days. Effects on dissolution were evaluated in a 14-day dissolution study. Set time increased to over 1 h for groups containing tobramycin, although vancomycin had a minimal effect. Pellets continued to elute antibiotics throughout the 42-day elution study, suggesting efficacy for the treatment or prevention of orthopedic infections. BVF containing vancomycin or tobramycin showed similar dissolution at 14 days compared to BVF without antibiotics; however, BVF containing both antibiotics showed significantly more dissolution.

In Vitro Mechanical Properties of a Calcium Silicate Based Bone Void Filler

2006 ◽  
pp. 829-832 ◽  
Author(s):  
Håkan Engqvist ◽  
S. Edlund ◽  
Gunilla Gómez-Ortega ◽  
Jesper Lööf ◽  
Leif Hermansson
Keyword(s):  
Mechanical Properties ◽  
Calcium Silicate ◽  
Bone Void Filler ◽  
Bone Void

scholarly journals Development and Evaluation of an Injectable Chitosan/β-Glycerophosphate Paste as a Local Antibiotic Delivery System for Trauma Care

2018 ◽  
Vol 9 (4) ◽  
pp. 56 ◽  
Author(s):  
Logan Boles ◽  
Christopher Alexander ◽  
Leslie Pace ◽  
Warren Haggard ◽  
Joel Bumgardner ◽  
...  
Keyword(s):  
Delivery System ◽  
Infection Prevention ◽  
Wound Site ◽  
Ejection Force ◽  
Relative Viability ◽  
Further Development ◽  
Local Antibiotic ◽  
Antibiotic Delivery

Complex open musculoskeletal wounds are a leading cause of morbidity worldwide, partially due to a high risk of bacterial contamination. Local delivery systems may be used as adjunctive therapies to prevent infection, but they may be nondegradable, possess inadequate wound coverage, or migrate from the wound site. To address this issue, a thermo-responsive, injectable chitosan paste was fabricated by incorporating beta-glycerophosphate. The efficacy of thermo-paste as an adjunctive infection prevention tool was evaluated in terms of cytocompatibility, degradation, antibacterial, injectability, and inflammation properties. In vitro studies demonstrated thermo-paste may be loaded with amikacin and vancomycin and release inhibitory levels for at least 3 days. Further, approximately 60% of thermo-paste was enzymatically degraded within 7 days in vitro. The viability of cells exposed to thermo-paste exceeded ISO 10993-5 standards with approximately 73% relative viability of a control chitosan sponge. The ejection force of thermo-paste, approximately 20 N, was lower than previously studied paste formulations and within relevant clinical ejection force ranges. An in vivo murine biocompatibility study demonstrated that thermo-paste induced minimal inflammation after implantation for 7 days, similar to previously developed chitosan pastes. Results from these preliminary preclinical studies indicate that thermo-paste shows promise for further development as an antibiotic delivery system for infection prevention.

An Overview of the Percutaneous Antibiotic Delivery Technique for Osteomyelitis Treatment and a Case Study of Calcaneal Osteomyelitis

2017 ◽  
Vol 107 (6) ◽  
pp. 511-515 ◽  
Author(s):  
Jeffrey C. Karr
Keyword(s):  
Calcium Sulfate ◽  
Adjunctive Treatment ◽  
Case Presentation ◽  
Delivery Technique ◽  
Bone Void Filler ◽  
Bone Cortex ◽  
Bone Void ◽  
Carrier Vehicle ◽  
Antibiotic Delivery

Background:A percutaneous antibiotic delivery technique (PAD-T) used for the adjunctive management of osteomyelitis is presented.Methods:This surgical technique incorporates a calcium sulfate and hydroxyapatite (calcium phosphate) bone void filler acting as a carrier vehicle with either an antibiotic or an antifungal medicine, delivering this combination directly into the area of osteomyelitis.Results:The benefit of the PAD-T is reviewed with a case presentation of a successfully treated calcaneal osteomyelitis.Conclusions:No previously reported PAD-T using a simple bone cortex incision in the adjunctive treatment of osteomyelitis has been reported. The PAD-T safely and effectively uses a calcium sulfate and hydroxyapatite bone void filler carrier vehicle to deliver either an antibiotic or an antifungal medicine directly into the area of osteomyelitis.

scholarly journals In Vitro Efficacy of Antibiotics Released from Calcium Sulfate Bone Void Filler Beads

Materials ◽  
2018 ◽  
Vol 11 (11) ◽  
pp. 2265 ◽  
Author(s):  
Phillip Laycock ◽  
John Cooper ◽  
Robert Howlin ◽  
Craig Delury ◽  
Sean Aiken ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Calcium Sulfate ◽  
Joint Infection ◽  
Diffusion Method ◽  
Zone Of Inhibition ◽  
Disk Diffusion Method ◽  
Bone Void Filler ◽  
Biofilm Bacteria ◽  
Bone Void

15 different antibiotics were individually mixed with commercially available calcium sulfate bone void filler beads. The antibiotics were: amikacin, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, colistamethate sodium, daptomycin, gentamicin, imipenem/cilastatin, meropenem, nafcillin, rifampicin, teicoplanin, tobramycin and vancomycin. The efficacy of specific released antibiotics was validated by zone of inhibition (ZOI) testing using a modified Kirby–Bauer disk diffusion method against common periprosthetic joint infection pathogens. With a subset of experiments (daptomycin, rifampin, vancomycin alone and rifampin and vancomycin in combination), we investigated how release varied over 15 days using a repeated ZOI assay. We also tested the ability of these beads to kill biofilms formed by Staphylococcus epidermidis 35984, a prolific biofilm former. The results suggested that certain antibiotics could be combined and released from calcium sulfate with retained antibacterial efficacy. The daptomycin and rifampin plus vancomycin beads showed antimicrobial efficacy for the full 15 days of testing and vancomycin in combination with rifampin prevented resistant mutants. In the biofilm killing assay, all of the antibiotic combinations showed a significant reduction in biofilm bacteria after 24 h. The exposure time was an important factor in the amount of killing, and varied among the antibiotics.

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