Effect of Sonication on the Elution of Antibiotics from Polymethyl Methacrylate (PMMA).
Détails
Etat: Public
Version: Final published version
Licence: CC BY-NC 4.0
ID Serval
serval:BIB_A591138124B2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Effect of Sonication on the Elution of Antibiotics from Polymethyl Methacrylate (PMMA).
Périodique
Journal of bone and joint infection
ISSN
2206-3552 (Print)
ISSN-L
2206-3552
Statut éditorial
Publié
Date de publication
2017
Peer-reviewed
Oui
Volume
2
Numéro
4
Pages
208-212
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
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.
Mots-clé
antibiotic elution, bone cement, polymethyl methacrylate, prosthetic joint infection, sonication
Pubmed
Open Access
Oui
Création de la notice
09/12/2017 10:45
Dernière modification de la notice
20/08/2019 16:10