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Gentamicin loading of calcium phosphate implants: implications for cranioplasty

Jimmy Sundblom1, Sara Gallinetti2, Ulrik Birgersson3

  • 1Department of Neuroscience, Neurosurgery, Uppsala University Hospital, Akademiska sjukhuset, 751 85, Uppsala, Sweden. jimmy.sundblom@neuro.uu.se.

Acta Neurochirurgica
|May 2, 2019
PubMed
Abstract

Insights

Calcium phosphate (CaP) bone cement effectively releases gentamicin, an antibiotic crucial for preventing surgical site infections (SSI) in cranioplasty. This local delivery method shows promise for reducing Staphylococcus infections post-surgery.

Area of Science:

  • Biomaterials Science
  • Infectious Disease Research
  • Neurosurgery

Background:

  • Surgical site infections (SSI) pose an 8-9% risk in cranioplasty procedures.
  • Staphylococcus species, known for biofilm formation, are primary causes of these infections.
  • Local antibiotic delivery, specifically gentamicin, may reduce early postoperative SSI compared to systemic administration.

Purpose of the Study:

  • To evaluate the potential of local antibiotic delivery for cranioplasty.
  • To assess drug release profiles of gentamicin from different biomaterials.
  • To determine effective gentamicin concentrations against relevant bacterial strains.

Main Methods:

  • Drug release studies were conducted using calcium phosphate (CaP), polyetheretherketone (PEEK), and titanium (Ti) samples.
  • In vitro microbiological assays utilized Staphylococcus aureus (SA) and Staphylococcus epidermidis (SE) strains.
  • Clinically relevant bacterial concentrations were established for testing.

Main Results:

  • Only CaP samples demonstrated gentamicin retention and sustained release over time.
  • Ti and PEEK samples showed no significant drug uptake or release.
  • A gentamicin loading concentration of 400 μg/ml proved effective against both SA and SE in vitro.

Conclusions:

  • Calcium phosphate is the only suitable material among those tested for gentamicin loading.
  • An initial gentamicin loading concentration of 400 μg/ml appears effective.
  • This approach may offer clinical benefits in preventing cranioplasty SSIs.
Keywords:
Calcium phosphateGentamicinPEEKStaphylococcusTitaniumUptake-release

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