Back David Alexander, Bormann Nicole, Calafi Arash, Zech Julie, Garbe Leif Alexander, Müller Martin, Willy Christian, Schmidmaier Gerhard, Wildemann Britt
Department of Traumatology and Orthopaedics, Septic and Reconstructive Surgery, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany.
Julius Wolff Institute and Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Int Orthop. 2016 May;40(5):1039-47. doi: 10.1007/s00264-016-3142-2. Epub 2016 Feb 23.
Surgical procedures to prevent osteomyelitis after trauma can be supported by local application of antibiotics. This in-vitro study investigated the release and impact of antibiotics from implant coatings against bacteria associated with combat-related osteomyelitis.
K-wires were coated with poly(D,L-lactide) and ciprofloxacin, gentamicin, colistin, daptomycin or cefoxitin in different concentrations. The release was quantified and antimicrobial activity tested for different gram-positive or gram-negative bacteria, alone and in combination. To exclude toxic effects, primary osteoblast-like cells were exposed to antibiotic coating concentrations.
All antibiotics alone and in combination showed an initial burst release with dose dependent antimicrobial activity and no negative effects on osteoblast-like cells, except for cefoxitin.
Implant coatings can be customized with single or double antibiotic coatings to effectively fight different bacteria and also mixed infections in the treatment of a combat-acquired osteomyelitis. However, optimal drug load and degradation behaviour of individual antibiotics have to be considered.
创伤后预防骨髓炎的外科手术可通过局部应用抗生素来辅助。本体外研究调查了植入物涂层中抗生素对与战斗相关骨髓炎相关细菌的释放及影响。
克氏针涂覆有聚（D，L-丙交酯）以及不同浓度的环丙沙星、庆大霉素、黏菌素、达托霉素或头孢西丁。对不同革兰氏阳性或革兰氏阴性细菌单独及联合检测释放量及抗菌活性。为排除毒性作用，将原代成骨样细胞暴露于抗生素涂层浓度下。
除头孢西丁外，所有抗生素单独及联合使用均表现出初始的突释，具有剂量依赖性抗菌活性，且对成骨样细胞无负面影响。
植入物涂层可定制为单抗生素涂层或双抗生素涂层，以有效对抗不同细菌以及治疗战斗所致骨髓炎中的混合感染。然而，必须考虑各抗生素的最佳药物负载量及降解行为。
