The addition of antibiotics to fibrin glue
1Department of Pharmacy Practice, School of Pharmacy, Southwestern Oklahoma State University, Weatherford 73096, USA.
Abstract:
Fibrin glue is composed of two separate solutions of fibrinogen and thrombin. When mixed together, these two solutions mimic the final stages of the clotting cascade to form a fibrin clot. Because the resulting fibrin patch is a good medium for microbial growth, the addition of antibiotics to one of the components of fibrin glue has been shown to reduce postoperative infections. Seventeen different antibiotics have been investigated in vitro. Of the 17, cefotaxime, mezlocillin, gentamicin, neomycin, and polymixin B, when added to fibrin glue, can decrease the rate of clot formation or the strength of the resultant fibrin clot. Further work is necessary to characterize the effect the addition of antibiotics has on the rate and strength of fibrin clotting and to determine what effect low systemic levels of antibiotics might have on antibiotic resistance patterns.
Insights
Adding antibiotics to fibrin glue may reduce infections but can affect clot formation. Further research is needed to understand the impact of these antibiotic-fibrin glue combinations on clotting and resistance patterns.
Area of Science:
- Biochemistry
- Pharmacology
- Surgical Innovation
Background:
- Fibrin glue, a hemostatic agent, mimics natural clotting by combining fibrinogen and thrombin.
- Fibrin glue's composition makes it susceptible to microbial contamination, increasing postoperative infection risk.
- Antibiotic incorporation into fibrin glue is a strategy to mitigate surgical site infections.
Purpose of the Study:
- To investigate the in vitro effects of various antibiotics on fibrin glue properties.
- To identify antibiotics that do not compromise fibrin clot formation or strength.
- To assess the potential impact of antibiotic-modified fibrin glue on resistance patterns.
Main Methods:
- In vitro testing of 17 different antibiotics added to fibrin glue components.
- Evaluation of the impact of antibiotics on the rate of fibrin clot formation.
- Assessment of the effect of antibiotics on the mechanical strength of the fibrin clot.
Main Results:
- Five antibiotics (cefotaxime, mezlocillin, gentamicin, neomycin, polymixin B) were found to alter fibrin clot formation rate or strength.
- The specific effects varied among the tested antibiotics.
- No antibiotics were identified as having zero impact on clot properties.
Conclusions:
- The addition of certain antibiotics to fibrin glue can negatively affect its clotting kinetics and mechanical integrity.
- Careful selection and further characterization of antibiotic-fibrin glue formulations are required.
- Systemic effects of low-dose antibiotic release from fibrin glue on resistance warrant investigation.
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