Antibiotics (Nov 2023)

Vancomycin Elution Kinetics of Four Antibiotic Carriers Used in Orthopaedic Surgery: In Vitro Study over 42 Days

  • Maria Anna Smolle,
  • Hana Murtezai,
  • Tobias Niedrist,
  • Florian Amerstorfer,
  • Nina Hörlesberger,
  • Lukas Leitner,
  • Sebastian Martin Klim,
  • Reingard Glehr,
  • Raju Ahluwalia,
  • Andreas Leithner,
  • Mathias Glehr

DOI
https://doi.org/10.3390/antibiotics12111636
Journal volume & issue
Vol. 12, no. 11
p. 1636

Abstract

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This study aimed to analyse and compare the vancomycin elution kinetics of four biodegradable, osteoconductive antibiotic carriers used in clinical practice within a 42-day in vitro setting. Carriers A and D already contained vancomycin (1.1 g and 0.247 g), whereas carriers B and C were mixed with vancomycin according to the manufacturer’s recommendations (B: 0.83 g and C: 0.305 g). At nine time points, 50% (4.5 mL) of the elution sample was removed and substituted with the same amount of PBS. Probes were analysed with a kinetic microparticle immunoassay. Time-dependent changes in vancomycin concentrations for each carrier and differences between carriers were analysed. Mean initial antibiotic levels were highest for carrier A (37.5 mg/mL) and lowest for carrier B (5.4 mg/mL). We observed time-dependent, strongly negative linear elution kinetics for carriers A (−0.835; p p p p = 0.040). A carrier consisting of allogenic bone chips showed the highest vancomycin-to-carrier ratio and the largest elution over the study period. Whilst vancomycin concentrations were still measurable at 42 days for all carriers, carrier A provided a higher drug-to-carrier ratio and a more consistent antibiotic-releasing profile.

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