Effect of Sonication on the Elution of Antibiotics from Polymethyl Methacrylate (PMMA).

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_A591138124B2
Type
Article: article from journal or magazin.
Collection
Publications
Title
Effect of Sonication on the Elution of Antibiotics from Polymethyl Methacrylate (PMMA).
Journal
Journal of bone and joint infection
Author(s)
Kummer A., Tafin U.F., Borens O.
ISSN
2206-3552 (Print)
ISSN-L
2206-3552
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
2
Number
4
Pages
208-212
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Background: In the setting of prosthetic joint infections treated with a two-stage procedure, spacers can be sonicated after removal. We hypothesize that the sonication process may cause an increased elution of antibiotics from the spacer, leading to elevated concentrations of antibiotics in the sonication fluid inhibiting bacterial growth. We aimed to evaluate in vitro the influence of sonication on the elution of antibiotics from polymethyl methacrylate (PMMA) over time and to determine whether these concentrations are above the minimum inhibitory concentrations (MIC) for microorganisms relevant in prosthetic joint infections. Methods: PMMA blocks impregnated with vancomycin, fosfomycin, gentamicin or daptomycin were incubated in phosphate-buffered saline (PBS) at 37°C for up to 6 weeks. PBS was changed once a week. Concentrations were determined from samples of each antibiotic every week, and after 5 minutes of sonication at 2, 4 and 6 weeks. Results: With sonication there was a trend toward an increase of the elution of antibiotics. This increase was significant for vancomycin at 2 and 4 weeks (p=0.008 and 0.002 respectively) and for fosfomycin at 2 weeks (p=0.01). Conclusion: The effect of sonication could play a role in clinical results, especially for daptomycin and gentamicin for which the MIC is close to the concentration of antibiotics at 4 and 6 weeks. We conclude that elution of antibiotics from PMMA along with the effect of sonication could inhibit bacterial growth from spacers, resulting in false negative results in the setting of two-stage exchange procedures for prosthetic joint infections.

Keywords
antibiotic elution, bone cement, polymethyl methacrylate, prosthetic joint infection, sonication
Pubmed
Open Access
Yes
Create date
09/12/2017 9:45
Last modification date
20/08/2019 15:10
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