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Testing of antibiotic releasing implant coatings to fight bacteria in combat-associated osteomyelitis – an in-vitro study

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

We would like to thank Mrs. Catrin Strobel for her support in planning the study and release kinetics calculations.

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Authors and Affiliations

  1. Department of Traumatology and Orthopaedics, Septic and Reconstructive Surgery, Bundeswehr Hospital Berlin, Scharnhorststrasse 13, 10115, Berlin, Germany

    David Alexander Back & Christian Willy

  2. Julius Wolff Institute and Berlin-Brandenburg Center for Regenerative Therapies, Charité – Universitätsmedizin Berlin, Berlin, Germany

    David Alexander Back, Nicole Bormann & Britt Wildemann

  3. Department of Orthopedic Surgery, University of California, Davis, CA, USA

    Arash Calafi

  4. Department of Biotechnology, Institute of Bioanalytics, Technische Universität Berlin, Berlin, Germany

    Julie Zech & Leif Alexander Garbe

  5. Research Institute for Special Analyses, Research and Teaching Institute for Brewing in Berlin (VLB), Berlin, Germany

    Julie Zech & Leif Alexander Garbe

  6. Department of Medicine, Central Institute of the Bundeswehr Medical Service Kiel, Berlin Branch, Berlin, Germany

    Martin Müller

  7. Department for Orthopaedics, Traumatology and Paraplegiology, University of Heidelberg, Heidelberg, Germany

    Gerhard Schmidmaier

Authors
  1. David Alexander Back
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  2. Nicole Bormann
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  7. Christian Willy
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  9. Britt Wildemann
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Corresponding author

Correspondence to David Alexander Back.

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Funding

This study was supported by the Sanitätsdienst der Bundeswehr (SoFo-01 F2-S-121213) and partially supported by the Bundesministerium für Bildung und Forschung (BMBF, FKZ 1315848A).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The local ethical committee of the Charité – Universitätsmedizin Berlin gave its approval (approval number: EA4/035/14).

Informed consent

Informed consent was obtained from the patient whose cells were used in the study.

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Back, D.A., Bormann, N., Calafi, A. et al. Testing of antibiotic releasing implant coatings to fight bacteria in combat-associated osteomyelitis – an in-vitro study. International Orthopaedics (SICOT) 40, 1039–1047 (2016). https://doi.org/10.1007/s00264-016-3142-2

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  • DOI: https://doi.org/10.1007/s00264-016-3142-2

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