Gentamicin-PMMA beads. Pharmacokinetic and nephrotoxicological study.

Five patients treated with gentamicin-polymethylmethacrylate (PMMA) beads were monitored during the treatment of nine to 14 days. Kinetic data of the gentamicin delivery were gathered constantly by multiple samples of blood and urine. The treatment with 48-360 beads caused a gentamicin serum concentration of 0.03-0.4 micrograms/ml and a renal excretion rate of 3-40 micrograms/min. The total amount of gentamicin excreted after the whole treatment was 20%-70%, with an in vivo half-life of 5.7-10 days. The gentamicin appeared to be released constantly during the entire treatment (nine to 14 days); the beads are kinetically slow release carriers. Despite precise measurement of tubular and glomerular renal function, no nephrotoxicity could be demonstrated. This local antibiotic gentamicin therapy may use the blood bone barrier effectively as a protection of the body against a very high local gentamicin concentration.