David Alexander Back1,2, Nicole Bormann3, Arash Calafi4, Julie Zech5,6, Leif Alexander Garbe5,6, Martin Müller7, Christian Willy8, Gerhard Schmidmaier9, Britt Wildemann3. 1. Department of Traumatology and Orthopaedics, Septic and Reconstructive Surgery, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany. david.back@charite.de. 2. Julius Wolff Institute and Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany. david.back@charite.de. 3. Julius Wolff Institute and Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany. 4. Department of Orthopedic Surgery, University of California, Davis, CA, USA. 5. Department of Biotechnology, Institute of Bioanalytics, Technische Universität Berlin, Berlin, Germany. 6. Research Institute for Special Analyses, Research and Teaching Institute for Brewing in Berlin (VLB), Berlin, Germany. 7. Department of Medicine, Central Institute of the Bundeswehr Medical Service Kiel, Berlin Branch, Berlin, Germany. 8. Department of Traumatology and Orthopaedics, Septic and Reconstructive Surgery, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany. 9. Department for Orthopaedics, Traumatology and Paraplegiology, University of Heidelberg, Heidelberg, Germany.
Abstract
PURPOSE: Surgical procedures to prevent osteomyelitis after trauma can be supported by local application of antibiotics. This in-vitro study investigated the release and impact of antibiotics from implant coatings against bacteria associated with combat-related osteomyelitis. METHODS: K-wires were coated with poly(D,L-lactide) and ciprofloxacin, gentamicin, colistin, daptomycin or cefoxitin in different concentrations. The release was quantified and antimicrobial activity tested for different gram-positive or gram-negative bacteria, alone and in combination. To exclude toxic effects, primary osteoblast-like cells were exposed to antibiotic coating concentrations. RESULTS: All antibiotics alone and in combination showed an initial burst release with dose dependent antimicrobial activity and no negative effects on osteoblast-like cells, except for cefoxitin. CONCLUSIONS: Implant coatings can be customized with single or double antibiotic coatings to effectively fight different bacteria and also mixed infections in the treatment of a combat-acquired osteomyelitis. However, optimal drug load and degradation behaviour of individual antibiotics have to be considered.
PURPOSE: Surgical procedures to prevent osteomyelitis after trauma can be supported by local application of antibiotics. This in-vitro study investigated the release and impact of antibiotics from implant coatings against bacteria associated with combat-related osteomyelitis. METHODS: K-wires were coated with poly(D,L-lactide) and ciprofloxacin, gentamicin, colistin, daptomycin or cefoxitin in different concentrations. The release was quantified and antimicrobial activity tested for different gram-positive or gram-negative bacteria, alone and in combination. To exclude toxic effects, primary osteoblast-like cells were exposed to antibiotic coating concentrations. RESULTS: All antibiotics alone and in combination showed an initial burst release with dose dependent antimicrobial activity and no negative effects on osteoblast-like cells, except for cefoxitin. CONCLUSIONS: Implant coatings can be customized with single or double antibiotic coatings to effectively fight different bacteria and also mixed infections in the treatment of a combat-acquired osteomyelitis. However, optimal drug load and degradation behaviour of individual antibiotics have to be considered.
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Authors: Elysia A Masters; Ryan P Trombetta; Karen L de Mesy Bentley; Brendan F Boyce; Ann Lindley Gill; Steven R Gill; Kohei Nishitani; Masahiro Ishikawa; Yugo Morita; Hiromu Ito; Sheila N Bello-Irizarry; Mark Ninomiya; James D Brodell; Charles C Lee; Stephanie P Hao; Irvin Oh; Chao Xie; Hani A Awad; John L Daiss; John R Owen; Stephen L Kates; Edward M Schwarz; Gowrishankar Muthukrishnan Journal: Bone Res Date: 2019-07-15 Impact factor: 13.567