Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).
Department of Endocrinology and Metabolism, Sir Run Run Shaw Hospital Affiliated with School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).
Med Sci Monit. 2018 Feb 8;24:797-802. doi: 10.12659/msm.908776.
BACKGROUND Calcium phosphate cement (CPC) has been applied as a biodegradable antibiotic carrier in osteomyelitis. However, the drug delivery, antibacterial efficacy, and degradation rate of CPC are insufficient and require further improvement in clinical application. MATERIAL AND METHODS Vancomycin-loaded CPC columns were prepared, and eluted in simulated body fluid. The drug delivery was assessed in the ultrasound group and control group by fluorescence polarization immunoassay. The antibacterial efficacy of vancomycin in the ultrasound group and control groups was investigated by standard plate count method. Low-frequency pulsed ultrasound (46.5 kHz, 900 mW/cm²) was used to produce a sinusoidal wave in the ultrasound groups. The percentage of residual weight was evaluated to assess the degradation of CPC. RESULTS The concentration and cumulatively released percentage of vancomycin in the ultrasound group were higher than that in the control group at each time point (p<0.05). The duration of vancomycin concentration over the level of minimum inhibitory concentration was significantly prolonged in the ultrasound group (p<0.05). Antibacterial efficacy of vancomycin in the ultrasound group was significantly greater than that in the control group with same concentration of vancomycin (p<0.05). The percentage of residual weight in the ultrasound group was significantly less than that in the control group (p<0.05). CONCLUSIONS Low-frequency pulsed ultrasound can enhance vancomycin release, prolong the duration of vancomycin concentration at high levels, and accelerate the degradation rate of vancomycin-loaded CPC.
磷酸钙骨水泥（CPC）已作为一种可生物降解的抗生素载体应用于骨髓炎。然而，CPC 的药物释放、抗菌效果和降解率仍不理想，在临床应用中仍需进一步改进。
制备载万古霉素 CPC 柱，在模拟体液中洗脱。通过荧光偏振免疫测定法在超声组和对照组评估药物释放。采用标准平板计数法研究超声组和对照组中万古霉素的抗菌效果。低频脉冲超声（46.5 kHz，900 mW/cm²）在超声组中产生正弦波。通过评估 CPC 的剩余重量百分比来评估其降解情况。
在每个时间点，超声组中万古霉素的浓度和累积释放百分比均高于对照组（p<0.05）。在超声组中，万古霉素浓度超过最低抑菌浓度的持续时间明显延长（p<0.05）。在相同浓度的万古霉素下，超声组的万古霉素抗菌效果明显大于对照组（p<0.05）。超声组的剩余重量百分比明显小于对照组（p<0.05）。
低频脉冲超声能增强万古霉素的释放，延长高水平万古霉素浓度的持续时间，并加速载万古霉素 CPC 的降解率。
