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Updated: Feb 23, 2026
A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
Published on: March 3, 2023
Elution kinetics of vancomycin and gentamicin from carriers and their effects on mesenchymal stem cell proliferation:
Tomas Kucera1, Lenka Ryskova2, Tomas Soukup3
1Department of Orthopaedic Surgery, University Hospital Hradec Kralove, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Sokolska 581, 500 05, Hradec Kralove, Czech Republic. tomas.kucera@fnhk.cz.
Background:
Musculoskeletal infections remain a major complication in orthopedic surgery. The local delivery of antibiotics provides the high levels required to treat an infection without systemic toxicity. However, the local toxicity of antibiotic carriers to the mesenchymal stem cells, as a result of both the peak concentrations and the type of carrier, may be significant.
Methods:
To address this concern, the elution kinetics of vancomycin and gentamicin from several commercially available antibiotic carriers and several carriers impregnated by a surgeon (10 ml of each sterile carrier were manually mixed with a 500 mg vancomycin and an 80 mg gentamicin solution, and the duration of impregnation was 30 min) were assessed. Moreover, the effects of these antibiotic carriers on stem cell proliferation were investigated. The following two types of stem cells were used: bone marrow and dental pulp stem cells.
Results:
The high eluted initial concentrations from antibiotic impregnated cancellous allogeneic bone grafts (which may be increased with the addition of fibrin glue) did not adversely affect stem cell proliferation. Moreover, an increased dental pulp stem cell proliferation rate in the presence of antibiotics was identified. In contrast to allogeneic bone grafts, a significant amount of antibiotics remained in the cement. Despite the favorable elution kinetics, the calcium carriers, bovine collagen carrier and freeze-dried bone exhibited decreased stem cell proliferation activity even in lower antibiotic concentrations compared with an allogeneic graft.
Conclusions:
This study demonstrated the benefits of antibiotic impregnated cancellous allogeneic bone grafts versus other carriers.
Insights
Antibiotic-loaded cancellous allogeneic bone grafts effectively deliver medication without harming mesenchymal stem cells. This bone graft carrier shows superior performance compared to other tested materials for orthopedic infections.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Stem Cell Biology
Background:
- Musculoskeletal infections are a significant surgical complication.
- Local antibiotic delivery offers high efficacy and low systemic toxicity.
- Antibiotic carriers can exhibit local toxicity to mesenchymal stem cells (MSCs).
Purpose of the Study:
- To assess elution kinetics of vancomycin and gentamicin from various antibiotic carriers.
- To investigate the impact of these carriers on bone marrow and dental pulp stem cell proliferation.
- To identify optimal carriers for local antibiotic delivery in orthopedic surgery.
Main Methods:
- Evaluated elution kinetics of vancomycin and gentamicin from commercial and surgeon-prepared carriers.
- Assessed stem cell proliferation (bone marrow and dental pulp MSCs) in the presence of carriers.
- Compared antibiotic elution and stem cell response across different carrier types.
Main Results:
- Antibiotic-impregnated cancellous allogeneic bone grafts showed no adverse effects on MSC proliferation.
- Increased dental pulp stem cell proliferation was observed with antibiotic presence.
- Cement carriers retained significant antibiotics, while calcium, collagen, and freeze-dried bone carriers reduced MSC proliferation.
Conclusions:
- Antibiotic-impregnated cancellous allogeneic bone grafts are beneficial for local antibiotic delivery.
- This carrier type demonstrates superior biocompatibility with MSCs compared to other tested materials.
- Cancellous allogeneic bone grafts represent a promising strategy for managing orthopedic infections.
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