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Treatment with Vancomycin Loaded Calcium Sulphate and Autogenous Bone in an Improved Rabbit Model of Bone Infection

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Published on: March 14, 2019

Vancomycin elution from a biphasic ceramic bone substitute.

M Stravinskas¹, M Nilsson², A Vitkauskiene¹

¹Orthopaedic Surgeon, Lithuanian University of Health, Kaunas, Lithuania.

Bone & Joint Research

|March 28, 2019

Summary

This summary is machine-generated.

This study shows vancomycin elution from a biphasic ceramic bone substitute provides high local antibiotic levels for hip surgery patients. The ceramic carrier ensures sustained release over weeks with safe systemic levels, aiding infection prevention.

Keywords:

Antibiotics Bone graft substitute Bone infection Elution Prevention Vancomycin

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Area of Science:

Orthopedics
Biomaterials Science
Pharmacokinetics

Background:

Injectable ceramic bone substitutes are used to augment fixation in hip fracture surgery.
Understanding antibiotic release from these carriers is crucial for optimizing treatment and preventing infection.

Purpose of the Study:

To analyze the long-term release of vancomycin from a biphasic ceramic carrier in patients undergoing major hip surgery.
To assess local and systemic vancomycin concentrations over time.
To evaluate the safety and efficacy of vancomycin elution for infection prophylaxis.

Main Methods:

Nine patients with trochanteric hip fractures received internal fixation augmented with an injectable ceramic bone substitute containing vancomycin.
Drain fluid, blood, and urine were collected simultaneously to monitor vancomycin concentrations.
Pharmacokinetic analysis was performed to determine elution profiles and systemic absorption.

Main Results:

Peak drain fluid vancomycin concentration was observed within six hours post-surgery, decreasing linearly over 2.5 days.
Urine vancomycin levels peaked within two days and reached zero by 20 days.
Systemic vancomycin concentrations in blood serum remained low and decreased to undetectable levels within four days.

Conclusions:

This is the first study to report long-term vancomycin release from a biphasic injectable ceramic bone substitute.
The ceramic carrier demonstrated high, targeted local vancomycin levels with sustained release up to three weeks.
Systemic vancomycin levels were below toxic thresholds, suggesting the material is effective for infection prevention in hip surgery.