- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Amikacin & meropenem impregnated calcium sulfate beads effective for orthopaedic infections
New York, USA: The study by LEVACK et al provides important novel data regarding the utility of amikacin, meropenem and dalbavancin as alternative choices to place in CaSO4 carriers when treating orthopaedic infections.
The presence of sessile bacteria within biofilm exhibit alternative resistance mechanisms compared to similar bacteria in planktonic form. The challenges of treating biofilms clinically is an area of ongoing research. Investigating alternative local delivery mechanisms could permit surgeons to broaden the list of antibiotics available for treatment.
There has been increasing interest in the use of a synthetic absorbable calcium sulfate (CaSO4) for local antibiotic delivery in orthopaedic infections.
LEVACK et al conducted a study to quantify elution kinetics of six antibiotics (amikacin, meropenem, fosfomycin, minocycline, cefazolin, and dalbavancin) from a clinically relevant CaSO4 bead model and compare elution and antimicrobial activity to the current clinical gold standards: vancomycin and tobramycin.
The antibiotics amikacin, meropenem, fosfomycin, and minocycline are active against resistant bacteria and are used clinically in difficult to treat gram‐negative infections; cefazolin is effective against methicillin‐sensitive gram‐positive pathogens; and dalbavancin is a novel lipoglycopeptide that has remarkable efficacy against methicillin‐resistant Staphylococcus aureus and vancomycin‐resistant enterococcus while being less nephrotoxic and hepatotoxic than vancomycin.
Antibiotic‐loaded synthetic CaSO4 beads were immersed in phosphate buffered saline and incubated at 37°C. Eluent was harvested at eight time points over 28 days. Antibiotic concentrations were measured by high performance liquid chromatography to quantify elution rates. CaSO4 beads demonstrated burst release kinetics.
Dalbavancin, cefazolin, and minocycline all demonstrated similar elution profiles to vancomycin.
Amikacin and meropenem demonstrated favorable elution profiles and durations of above‐ minimum inhibitory concentration when compared to tobramycin.
The authors concluded that - this study provides important novel data regarding the utility of amikacin, meropenem and dalbavancin as alternative choices to place in CaSO4 carriers when treating orthopaedic infections.
The conditions set here for identifying antibiotic suitability when using CaSO4 carriers highlights the need for surgeons to learn more about how elution patterns and elution rates differ among antibiotics, and that taking an individualized approach to antibiotic choice and carrier is needed if orthopaedic infection cure rates are to improve.
This study does not inform the clinical efficacy of these antibiotics for clinical infections or in the setting of sessile bacteria within biofilms. Future studies using in vivo models are needed to provide a better understanding of both the kinetics of antibiotic elution from calcium sulfate and the activity of alternative antibiotics against both planktonic and sessile bacteria.
Further reading:
Identifying alternative antibiotics that elute from calcium sulfate beads for treatment of orthopedic infections.
Ashley E. Levack et al
The Journal of Orthopedic Research
DOI: 10.1002/jor.25135
MBBS, Dip. Ortho, DNB ortho, MNAMS
Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751