Cargando…
Elution Profiles of Synthetic CaSO(4) Hemihydrate Beads Loaded with Vancomycin and Tobramycin
BACKGROUNDS AND OBJECTIVES: The use of local antibiotic delivery vehicles is common in the management of biofilm-related infections as they provide high concentrations of local antibiotics while simultaneously avoiding complications from systemic toxicity. We present a 100% pure synthetic calcium su...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359161/ https://www.ncbi.nlm.nih.gov/pubmed/32328932 http://dx.doi.org/10.1007/s13318-020-00622-8 |
_version_ | 1783558991422423040 |
---|---|
author | Maale, Gerhard E. Eager, John J. Mohammadi, Daniel K. Calderon, Flavio A. |
author_facet | Maale, Gerhard E. Eager, John J. Mohammadi, Daniel K. Calderon, Flavio A. |
author_sort | Maale, Gerhard E. |
collection | PubMed |
description | BACKGROUNDS AND OBJECTIVES: The use of local antibiotic delivery vehicles is common in the management of biofilm-related infections as they provide high concentrations of local antibiotics while simultaneously avoiding complications from systemic toxicity. We present a 100% pure synthetic calcium sulfate hemi-hydrate mixed with 240 mg tobramycin and 500 mg vancomycin per 10 cc mixture for use in revision surgeries of periprosthetic joint infections (PJIs). The purified carrier demonstrates bioabsorbablity, promotion of bone growth, a physiologically favorable pH, and hydrophilicity. These unique properties may alleviate persistent postoperative wound drainage seen in patients with PJI. Our questions consist of two parts: (1) does the novel calcium sulfate carrier provide therapeutic concentrations of antibiotic locally that can kill biofilm related infections? (2) Are serum concentrations of antibiotic significant to cause concern for systemic toxicity? METHODS: To address these questions, we assayed the elution of antibiotic concentrations obtained from surgical drains and serum among 50 patients in the first 5 postoperative days. RESULTS: The elution of vancomycin and tobramycin was greatest on day 1 compared with those concentrations obtained on days 2, 3, 4, and 5; serum concentrations were largely undetectable. Our findings demonstrate that this calcium sulfate preparation provides therapeutic delivery of vancomycin and tobramycin locally at log 2–3 above the minimum inhibitory concentration (MIC), while avoiding toxic serum concentrations. CONCLUSIONS: When used in one-stage revision arthroplasties, the bioabsorbable, purified carrier delivers high concentrations of antibiotic while avoiding systemic toxicity. |
format | Online Article Text |
id | pubmed-7359161 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-73591612020-07-16 Elution Profiles of Synthetic CaSO(4) Hemihydrate Beads Loaded with Vancomycin and Tobramycin Maale, Gerhard E. Eager, John J. Mohammadi, Daniel K. Calderon, Flavio A. Eur J Drug Metab Pharmacokinet Original Research Article BACKGROUNDS AND OBJECTIVES: The use of local antibiotic delivery vehicles is common in the management of biofilm-related infections as they provide high concentrations of local antibiotics while simultaneously avoiding complications from systemic toxicity. We present a 100% pure synthetic calcium sulfate hemi-hydrate mixed with 240 mg tobramycin and 500 mg vancomycin per 10 cc mixture for use in revision surgeries of periprosthetic joint infections (PJIs). The purified carrier demonstrates bioabsorbablity, promotion of bone growth, a physiologically favorable pH, and hydrophilicity. These unique properties may alleviate persistent postoperative wound drainage seen in patients with PJI. Our questions consist of two parts: (1) does the novel calcium sulfate carrier provide therapeutic concentrations of antibiotic locally that can kill biofilm related infections? (2) Are serum concentrations of antibiotic significant to cause concern for systemic toxicity? METHODS: To address these questions, we assayed the elution of antibiotic concentrations obtained from surgical drains and serum among 50 patients in the first 5 postoperative days. RESULTS: The elution of vancomycin and tobramycin was greatest on day 1 compared with those concentrations obtained on days 2, 3, 4, and 5; serum concentrations were largely undetectable. Our findings demonstrate that this calcium sulfate preparation provides therapeutic delivery of vancomycin and tobramycin locally at log 2–3 above the minimum inhibitory concentration (MIC), while avoiding toxic serum concentrations. CONCLUSIONS: When used in one-stage revision arthroplasties, the bioabsorbable, purified carrier delivers high concentrations of antibiotic while avoiding systemic toxicity. Springer International Publishing 2020-04-23 2020 /pmc/articles/PMC7359161/ /pubmed/32328932 http://dx.doi.org/10.1007/s13318-020-00622-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Research Article Maale, Gerhard E. Eager, John J. Mohammadi, Daniel K. Calderon, Flavio A. Elution Profiles of Synthetic CaSO(4) Hemihydrate Beads Loaded with Vancomycin and Tobramycin |
title | Elution Profiles of Synthetic CaSO(4) Hemihydrate Beads Loaded with Vancomycin and Tobramycin |
title_full | Elution Profiles of Synthetic CaSO(4) Hemihydrate Beads Loaded with Vancomycin and Tobramycin |
title_fullStr | Elution Profiles of Synthetic CaSO(4) Hemihydrate Beads Loaded with Vancomycin and Tobramycin |
title_full_unstemmed | Elution Profiles of Synthetic CaSO(4) Hemihydrate Beads Loaded with Vancomycin and Tobramycin |
title_short | Elution Profiles of Synthetic CaSO(4) Hemihydrate Beads Loaded with Vancomycin and Tobramycin |
title_sort | elution profiles of synthetic caso(4) hemihydrate beads loaded with vancomycin and tobramycin |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359161/ https://www.ncbi.nlm.nih.gov/pubmed/32328932 http://dx.doi.org/10.1007/s13318-020-00622-8 |
work_keys_str_mv | AT maalegerharde elutionprofilesofsyntheticcaso4hemihydratebeadsloadedwithvancomycinandtobramycin AT eagerjohnj elutionprofilesofsyntheticcaso4hemihydratebeadsloadedwithvancomycinandtobramycin AT mohammadidanielk elutionprofilesofsyntheticcaso4hemihydratebeadsloadedwithvancomycinandtobramycin AT calderonflavioa elutionprofilesofsyntheticcaso4hemihydratebeadsloadedwithvancomycinandtobramycin |