A dual PMMA/calcium sulfate carrier of vancomycin is more effective than PMMA‐vancomycin at inhibiting Staphylococcus aureus growth in vitro

Both antibiotic‐impregnated poly(methyl acrylate, methyl methacrylate) (PMMA) and antibiotic‐impregnated calcium sulfate have been successfully used as local antibiotic delivery vehicles for the management of chronic osteomyelitis. Here, we examined the antibiotic elution characteristics and antibacterial properties of a composite drug delivery system consisting of PMMA/calcium sulfate carrying vancomycin (dual carrier‐v) against Staphylococcus aureus, with PMMA loaded with vancomycin (PMMA‐v) as a control. Vancomycin gradually degraded from dual carrier‐v and PMMA‐v up to about 8 and 6 weeks, respectively. At different elution time points, the inhibition zones of the dual carrier‐v were larger than the inhibition zones of the PMMA‐v (P < 0.05). The colony inhibition rate of the dual carrier‐v was 95.57%, whereas it was 77.87% for PMMA‐v. Scanning electron microscopy was used to demonstrate biofilm formation on the surface of plates treated with vancomycin‐unloaded PMMA, whereas there was no biofilm formation on the surface of plates treated with dual carrier‐v or PMMA‐v. The dual carrier‐v was more effective at antibacterial adhesion at each time point after immersion in simulated body fluid as compared with PMMA‐v (P < 0.05). In conclusion, our results suggest that the dual carrier‐v can release higher concentrations of antibiotics and inhibit bacteria growth more effectively in vitro as compared with PMMA‐v. The dual carrier‐v thus may have potential as an alternative strategy for osteomyelitis management.