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Characterization of daptomycin-loaded antibiotic cement
Lige Kaplan1, Michael Kurdziel, Kevin C Baker
1Department of Orthopaedic Surgery, Beaumont Health System, Royal Oak, Michigan 48073, USA.
Orthopedics
|April 13, 2012
Summary
Adding tobramycin to daptomycin in polymethylmethacrylate (PMMA) cement enhances antibiotic elution and improves mechanical strength. Optimal concentrations are 2g daptomycin and 3.6g tobramycin per 40g PMMA for joint arthroplasty.
Area of Science:
- Biomaterials Science
- Orthopedic Surgery
- Infectious Disease
Background:
- Polymethylmethacrylate (PMMA) bone cement is crucial for total joint arthroplasty.
- Periprosthetic infections are a significant complication requiring antibiotic treatment.
- The elution kinetics and mechanical impact of antibiotics in PMMA are not fully understood.
Purpose of the Study:
- To characterize daptomycin release from PMMA bone cement.
- To evaluate the effect of tobramycin on daptomycin elution.
- To assess the impact of antibiotics on PMMA mechanical properties.
Main Methods:
- Vacuum mixing of varying daptomycin and tobramycin concentrations in PMMA.
- In vitro elution studies.
- High-performance liquid chromatography (HPLC) for quantifying eluted daptomycin.
- Compressive loading tests to evaluate mechanical properties.
Main Results:
- Increased tobramycin concentration enhanced daptomycin elution.
- Antibiotic addition improved cement compressive strength post-elution.
- Binary antibiotic addition modified both elution and mechanical characteristics of PMMA.
Conclusions:
- The combination of tobramycin and daptomycin influences PMMA elution and mechanical properties.
- A specific ratio (2g daptomycin, 3.6g tobramycin per 40g PMMA) optimizes elution without compromising mechanical integrity.
- This finding supports enhanced infection control in total joint arthroplasty.
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