Trimethoprim Combined With Vancomycin and Gentamicin Composite Bone Cement In Vitro

Area of Science:

• Biomedical Engineering
• Infectious Diseases
• Pharmacology

Background:

• Bone infections pose significant clinical challenges, often requiring antibiotic-loaded bone cement for localized treatment.
• Vancomycin and gentamicin are commonly used antibiotics in bone cement, but their efficacy can be limited by bacterial resistance.
• Optimizing antibiotic combinations in bone cement is crucial for improving treatment outcomes and preventing complications.

Purpose of the Study:

• To investigate the impact of trimethoprim on the antibacterial activity of vancomycin- and gentamicin-loaded bone cement.
• To evaluate the effect of trimethoprim on the cytotoxicity and cell proliferation of bone cement formulations.
• To establish a scientific basis for the potential clinical application of trimethoprim-modified bone cement.

Main Methods:

• Bone cement samples were prepared with varying combinations of vancomycin, gentamicin, and trimethoprim.
• Antibacterial efficacy was determined using the plate diffusion method against Staphylococcus aureus.
• Cell viability, cytotoxicity, and proliferation were assessed using CCK8 assays.

Main Results:

• Increasing trimethoprim concentrations significantly expanded the antibacterial zones for both vancomycin- and gentamicin-based bone cements (p < 0.05).
• Vancomycin-trimethoprim combinations exhibited moderate cytotoxicity by day 5.
• Most formulations, including those with trimethoprim, demonstrated robust cell proliferation with minimal cytotoxicity (p < 0.05).

Conclusions:

• Trimethoprim addition effectively boosts the antibacterial efficacy of vancomycin and gentamicin bone cement.
• The combination of trimethoprim with vancomycin or gentamicin in bone cement appears to maintain acceptable cell viability.
• These findings support the potential clinical utility of trimethoprim-containing bone cement for treating bone infections.