In vitro study of elution kinetics and bio-activity of meropenem-loaded acrylic bone cement

Sumant Samuel,Binu S Mathew,Samuel B Chittaranjan,John A J Prakash,Balaji Veeraraghavan,Denise H Fleming

doi:10.1007/s10195-012-0191-1

Sumant Samuel, Binu S Mathew + Show 4 more

Open Access

https://doi.org/10.1007/s10195-012-0191-1

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Abstract

BackgroundUse of antibiotic-loaded acrylic bone cement to treat orthopaedic infections continues to remain popular, but resistance to routinely used antibiotics has led to the search for alternative, more effective antibiotics. We studied, in vitro, the elution kinetics and bio-activity of different concentrations of meropenem-loaded acrylic bone cement.MethodsMeropenem-loaded bone cement cylinders of different concentrations were serially immersed in normal saline. Elution kinetics was studied by measuring the drug concentration in the eluate, collected at pre-determined intervals, by high-performance liquid chromatography. Bio-activity of the eluate of two different antibiotic concentrations was tested for a period of 3 weeks against each of the following organisms: Staphylococcus aureus ATCC 2593 (MSSA), Enterococcus faecalis ATCC 29212, Pseudomonas aeruginosa ATCC 27853, Escherichia coli ATCC 25922, S. aureus ATCC 43300 (MRSA) and Klebsiella pneumoniae ATCC 700603 (ESBL).ResultsMeropenem elutes from acrylic bone cement for a period of 3–27 days depending on the concentration of antibiotic. Higher doses of antibiotic concentration resulted in greater elution of the antibiotic. The eluate was found to be biologically active against S. aureus ATCC 2593 (MSSA), P. aeruginosa ATCC 27853, E. coli ATCC 25922 and K. pneumoniae ATCC 700603 (ESBL) for a period of 3 weeks.ConclusionsThe elution of meropenem is in keeping with typical antibiotic-loaded acrylic bone cement elution characteristics. The use of high-dose meropenem-loaded acrylic bone cement seems to be an attractive option for treatment of resistant Gram-negative orthopaedic infections but needs to be tested in vivo.

Highlights

Multi-drug-resistant Gram-negative infections are frequently encountered in clinical practice [1]
The elution of meropenem is in keeping with typical antibiotic-loaded acrylic bone cement elution characteristics
The use of high-dose meropenem-loaded acrylic bone cement seems to be an attractive option for treatment of resistant Gram-negative orthopaedic infections but needs to be tested in vivo

Summary

Introduction

Multi-drug-resistant Gram-negative infections are frequently encountered in clinical practice [1]. Gram-negative organisms have been implicated in 10–20 % of implant-associated orthopaedic infections [5, 6]. Use of antibiotic-loaded acrylic bone cement to treat orthopaedic infections continues to remain popular, but resistance to routinely used antibiotics has led to the search for alternative, more effective antibiotics. In vitro, the elution kinetics and bio-activity of different concentrations of meropenem-loaded acrylic bone cement. Bio-activity of the eluate of two different antibiotic concentrations was tested for a period of 3 weeks against each of the following organisms: Staphylococcus aureus ATCC. Results Meropenem elutes from acrylic bone cement for a period of 3–27 days depending on the concentration of antibiotic. The eluate was found to be biologically active against S. aureus ATCC 2593 (MSSA), P. aeruginosa ATCC 27853, E. coli ATCC 25922 and K. pneumoniae ATCC 700603 (ESBL) for a period of 3 weeks

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