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Release of netilmicin and vancomycin from cancellous bone
Eivind Witsø1, Leif Persen, Pål Benum
1Department of Orthopaedic Surgery, University Hospital, Norwegian University of Science and Technology, Trondheim. eivind.witso@rit-no
Acta Orthopaedica Scandinavica
|June 25, 2002
Summary
Antibiotic impregnation of bone affects drug release. Higher concentrations and longer impregnation times increase netilmicin and vancomycin elution, with pH 7 favoring release. Bone morselization impacts netilmicin release.
Area of Science:
- Biomaterials Science
- Pharmacology
- Orthopedic Surgery
Background:
- Cancellous bone impregnation with antibiotics like netilmicin and vancomycin is crucial for preventing bone infections.
- Optimizing antibiotic release from impregnated bone is essential for effective treatment and minimizing resistance.
Purpose of the Study:
- To investigate the impact of various factors on the elution of netilmicin and vancomycin from impregnated cancellous bone.
- To assess the completeness of antibiotic release and in vivo serum levels after implantation.
Main Methods:
- Systematic variation of antibiotic concentration, impregnation time, pH, bone particle size, and antibiotic combinations.
- In vitro elution studies over 24 hours and 6 weeks.
- In vivo implantation in rabbit femur condyles with subsequent serum antibiotic level monitoring.
Main Results:
- Increased antibiotic concentration and longer impregnation times enhanced drug release.
- Netilmicin release was higher at pH 7 compared to pH 3 and favored fine bone particles.
- Combined antibiotic impregnation reduced vancomycin release; 99.9% of netilmicin eluted over 6 weeks.
- Peak serum netilmicin levels were 4.2 mg/L 2-3 hours post-implantation in rabbits.
Conclusions:
- Antibiotic release from impregnated bone is significantly influenced by impregnation parameters.
- Optimized impregnation protocols can control antibiotic elution profiles for potential therapeutic benefits.
- Netilmicin demonstrates predictable release and achievable serum concentrations following bone implantation.