In vitro elution characteristics of antibiotic laden BoneSource™, hydroxyapatite bone cement

A calcium phosphate - hydroxyapatite (HA) bone cement was loaded with varying concentrations of tobramycin and vancomycin and the elution properties of these antibiotics were evaluated. Nine groups of antibiotic loaded cement cylinders (N = 6 in each group) were prepared and placed in saline for 28 days. Elution rates of tobramycin and vancomycin from the HA cement were evaluated at high, medium, and low doses of incorporated antibiotic. Tobramycin elution rates did not vary according to dose (0.36, 0.18, and 0.09g). Vancomycin elution rates were also not significantly affected by dose (0.1 , 0.05 , and 0.025 g). The combination of tobramycin and vancomycin increased the elution rate of vancomycin for the medium and low dose of tobramycin. The dose of tobramycin did not affect its elution rate from the cement in the combined groups. Importantly, the concentration of antibiotic eluent stayed above the minimum inhibitory concentration for the entire 28 days for all groups except the medium and low dose of vancomycin alone. Overall, elution rates of both tobramycin and vancomycin in the calcium phosphate-HA cement were comparable to those from polymethylmethacryltate beads in vitro.