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Comparative study of antimicrobial release kinetics from polymethylmethacrylate.
Paloma Anguita-Alonso1, Mark S Rouse, Kerryl E Piper
1Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Clinical Orthopaedics and Related Research
|February 14, 2006
Summary
Polymethylmethacrylate beads release various antimicrobials, including cefazolin and rifampin, in vitro. Different antimicrobial elution profiles from polymethylmethacrylate were observed, suggesting suitability for orthopaedic infection management.
Area of Science:
- Orthopaedic surgery
- Infectious disease
- Materials science
Background:
- Polymethylmethacrylate (PMMA) loaded with vancomycin/aminoglycosides is standard for orthopaedic infections.
- Emerging antimicrobial resistance necessitates alternative treatment strategies.
Purpose of the Study:
- To evaluate in vitro release of diverse antimicrobials from PMMA beads.
- To assess the suitability of cefazolin, ciprofloxacin, gatifloxacin, levofloxacin, linezolid, and rifampin for PMMA incorporation.
Main Methods:
- PMMA beads loaded with antimicrobials (2.5%, 7.5%, 15%) were tested in a continuous flow chamber.
- Antimicrobial concentrations in outflow were quantified via bioassay at timed intervals.
Main Results:
- Observed bimodal release: initial rapid high concentration followed by sustained slow release.
- Elution profiles varied significantly among tested antimicrobials.
- Increased PMMA antimicrobial concentration correlated with higher peak concentrations and area under the curve.
Conclusions:
- Antimicrobial elution from PMMA is agent-specific.
- Cefazolin, ciprofloxacin, gatifloxacin, levofloxacin, linezolid, and rifampin demonstrate potential for PMMA-based orthopaedic infection management.