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In Vitro Efficacy of Antibiotics Released from Calcium Sulfate Bone Void Filler Beads

Phillip A Laycock1, John J Cooper2, Robert P Howlin3

  • 1Biocomposites Ltd., Keele Science Park, Keele, Staffordshire ST5 5NL, UK. pl@biocomposites.com.

Materials (Basel, Switzerland)
|November 16, 2018
PubMed

Insights

Calcium sulfate bone void fillers effectively release 15 antibiotics, maintaining antibacterial efficacy against infection pathogens. Combinations like daptomycin and rifampin/vancomycin show sustained antimicrobial activity and biofilm eradication.

Area of Science:

  • Biomaterials Science
  • Infectious Disease Research
  • Antibiotic Efficacy

Background:

  • Periprosthetic joint infections (PJIs) are a significant complication in orthopedic surgery.
  • Antibiotic-eluting bone void fillers are crucial for treating and preventing PJIs.
  • Calcium sulfate is a commonly used, resorbable carrier for antibiotic delivery.

Purpose of the Study:

  • To evaluate the sustained release and antibacterial efficacy of 15 different antibiotics incorporated into calcium sulfate bone void filler beads.
  • To assess the ability of antibiotic-loaded beads to eradicate biofilms formed by common pathogens.
  • To investigate the long-term efficacy and potential for preventing resistance with specific antibiotic combinations.

Main Methods:

  • Fifteen antibiotics were individually mixed with calcium sulfate bone void filler beads.
  • Antibiotic efficacy was validated using zone of inhibition (ZOI) testing against standard PJI pathogens.
  • Repeated ZOI assays over 15 days assessed antibiotic release kinetics for select antibiotics (daptomycin, rifampin, vancomycin).
  • Biofilm killing assays were performed using *Staphylococcus epidermidis* 35984.

Main Results:

  • All tested antibiotics released from calcium sulfate beads demonstrated antibacterial efficacy.
  • Daptomycin and rifampin plus vancomycin beads maintained antimicrobial efficacy for 15 days.
  • The combination of vancomycin and rifampin prevented the emergence of resistant mutants.
  • All tested antibiotic combinations significantly reduced biofilm bacteria within 24 hours.

Conclusions:

  • Calcium sulfate bone void fillers can effectively incorporate and release multiple antibiotics while retaining antibacterial activity.
  • Specific antibiotic combinations, such as daptomycin and rifampin/vancomycin, offer sustained efficacy and resistance prevention.
  • Antibiotic-eluting calcium sulfate beads show promise for treating PJIs and eradicating challenging biofilms.
Keywords:
antibioticsbiofilmcalcium sulfatereleasezone of inhibition

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