Treatment of osteomyelitis with antibiotic-soaked porous glass ceramic.

Abstract	We have developed a new drug delivery system using porous apatite-wollastonite glass ceramic (A-W GC) to treat osteomyelitis. A-W GC (porosity, 70% and 20% to 30%), or porous hydroxyapatite (HA) blocks (porosity 35% to 48%) used as controls, were soaked in mixtures of two antibiotics, isepamicin sulphate (ISP) and cefmetazole (CMZ) under high vacuum. We evaluated the release concentrations of the antibiotics from the blocks. The bactericidal concentration of ISP from A-W GC was maintained for more than 42 days, but that from HA decreased to below the detection limit after 28 days. The concentrations of CMZ from both materials were lower than those of ISP. An in vivo study using rabbit femora showed that an osseous concentration of ISP was maintained at eight weeks after implantation. Osteoconduction of the A-W GC block was good. Four patients with infected hip arthroplasties and one with osteomyelitis of the tibia have been treated with the new delivery system with excellent results.
Authors	K Kawanabe, Y Okada, Y Matsusue, H Iida, T Nakamura
Journal	The Journal of bone and joint surgery. British volume (J Bone Joint Surg Br) Vol. 80 Issue 3 Pg. 527-30 (May 1998) ISSN: 0301-620X [Print] England
PMID	9619951 (Publication Type: Journal Article)
Chemical References	Anti-Bacterial Agents Apatites Calcium Compounds Cephamycins Drug Implants Gentamicins Silicates Cefmetazole Durapatite isepamicin calcium silicate
Topics	Adult Animals Anti-Bacterial Agents (administration & dosage, pharmacokinetics) Apatites (chemistry) Arthroplasty, Replacement, Hip (adverse effects) Calcium Compounds (chemistry) Cefmetazole (administration & dosage, pharmacokinetics) Cephamycins (administration & dosage, pharmacokinetics) Ceramics (chemistry) Drug Delivery Systems Drug Implants Drug Therapy, Combination (administration & dosage, pharmacokinetics) Durapatite (chemistry) Female Femur (metabolism, surgery) Gentamicins (administration & dosage, pharmacokinetics) Glass (chemistry) Hip Prosthesis (adverse effects) Humans Male Middle Aged Osteomyelitis (drug therapy, metabolism) Pilot Projects Porosity Prosthesis-Related Infections (drug therapy) Rabbits Silicates (chemistry) Tibia (surgery) Time Factors

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