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Continuous wave ultrasound enhances vancomycin release and antimicrobial efficacy of antibiotic-loaded acrylic bone cement in vitro and in vivo.

Abstract
Although antibiotic-loaded bone cement (ALBC) is used as a drug delivery vehicle to decrease infection rates, the varied clinical effect of the antibiotic release remains controversial. The objective of this study is to investigate the enhancement of continuous wave ultrasound (CWU) on vancomycin release and antimicrobial efficacy of ALBC in vitro and in vivo. We measured vancomycin concentrations after a 0.5-h exposure of CWU. The results showed that CWU increased the drug elution by 2.57-27.44% when compared with the controls in vitro. Ultrasonic intensity and vancomycin load both had a significant effect on the cumulative drug elution at 10.5 h, with a significant interaction between each other. We also implanted ALBC specimens into hip joints of sixteen New Zealand White female rabbits after inoculations of Staphylococcus aureus around primary implants for 30 days. Vancomycin concentrations in the hip cavity and urinary elimination of vancomycin were both measured after intermittent exposures of CWU. The results showed that CWU increased local Tmax by 47.6 microg/mL and urinary elimination of vancomycin by 109.56 microg, but failed to prolong local T>MIC. On day 30 after the implantation, assessment in clinical performance, radiology, bacteriology, and histology all showed a tendency of decreased bacterial vitality and relieved inflammation in the infected hip treated by CWU. This study suggested that CWU could effectively enhance vancomycin release and antimicrobial efficacy of ALBC, which may be of clinical significance for treating prosthesis-related infections.
AuthorsShigui Yan, Xunzi Cai, Weiqi Yan, Xuesong Dai, Haobo Wu
JournalJournal of biomedical materials research. Part B, Applied biomaterials (J Biomed Mater Res B Appl Biomater) Vol. 82 Issue 1 Pg. 57-64 (Jul 2007) ISSN: 1552-4973 [Print] United States
PMID17078078 (Publication Type: Journal Article)
CopyrightCopyright 2006 Wiley Periodicals, Inc.
Chemical References
  • Anti-Bacterial Agents
  • Vancomycin
  • Polymethyl Methacrylate
Topics
  • Animals
  • Anti-Bacterial Agents (administration & dosage, pharmacokinetics)
  • Drug Delivery Systems
  • Female
  • Hip (microbiology, pathology, surgery)
  • Magnetic Resonance Imaging
  • Polymethyl Methacrylate
  • Prosthesis-Related Infections (prevention & control)
  • Rabbits
  • Staphylococcal Infections (prevention & control)
  • Staphylococcus aureus (drug effects)
  • Ultrasonics
  • Vancomycin (administration & dosage, pharmacokinetics)

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