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In vitro gentamicin release from commercially available calcium-phosphate bone substitutes influence of carrier type
Hein P Stallmann1, Chris Faber, Antonius L J J Bronckers
1Orthopaedic Surgery, VU Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. h.stallmann@vumc.nl
Background:
Polymethyl-methacrylate (PMMA) beads releasing antibiotics are used extensively to treat osteomyelitis, but require surgical removal afterwards because they do not degrade.
Methods:
As an alternative option, this report compares the in vitro gentamicin release profile from clinically used, biodegradable carrier-materials: six injectable cements and six granule-types. Cement cylinders and coated granules containing 3% gentamicin were submerged in dH2O and placed in a 48-sample parallel drug-release system. At regular intervals (30, 90, 180 min. and then every 24 h, for 21 days), the release fluid was exchanged and the gentamicin concentration was measured. The activity of released gentamicin was tested on Staphylococcus aureus.
Results:
All combinations showed initial burst-release of active gentamicin, two cements had continuous-release (17 days). The relative release of all cements (36-85%) and granules (30-62%) was higher than previously reported for injectable PMMA-cements (up to 17%) and comparable to other biodegradable carriers. From the cements residual gentamicin could be extracted, whereas the granules released all gentamicin that had adhered to the surface.
Conclusion:
The high release achieved shows great promise for clinical application of these biodegradable drug-carriers. Using the appropriate combination, the required release profile (burst or sustained) may be achieved.
Insights
Biodegradable drug carriers offer a promising alternative to polymethyl-methacrylate (PMMA) beads for treating osteomyelitis. These new materials demonstrate effective gentamicin release, potentially eliminating the need for surgical removal.
Area of Science:
- Biomaterials Science
- Drug Delivery Systems
- Infectious Disease Treatment
Background:
- Polymethyl-methacrylate (PMMA) beads are widely used for antibiotic delivery in osteomyelitis but necessitate surgical removal due to their non-degradable nature.
- This limitation highlights the need for alternative, biodegradable drug delivery systems.
Purpose of the Study:
- To compare the in vitro gentamicin release profiles of various biodegradable carrier materials against traditional PMMA beads.
- To evaluate the efficacy of released gentamicin against Staphylococcus aureus.
Main Methods:
- Six injectable cements and six granule-types were tested for gentamicin release over 21 days.
- Gentamicin concentration and activity in release fluid were measured at regular intervals.
- Release profiles were compared to established PMMA-based systems.
Main Results:
- All tested biodegradable carriers exhibited an initial burst release of active gentamicin.
- Two cement formulations provided continuous release for up to 17 days.
- Release percentages from biodegradable carriers (30-85%) significantly exceeded that of PMMA-cements (up to 17%).
Conclusions:
- Biodegradable drug carriers show significant promise for clinical applications in osteomyelitis treatment.
- The choice of carrier material can be tailored to achieve desired gentamicin release kinetics (burst or sustained).
- These materials may offer an improved therapeutic option by avoiding secondary surgical procedures.
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