Journal cover Journal topic
Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
Journal topic

Journal metrics

h5-index value: 15
h5-index15
Volume 2, issue 4
J. Bone Joint Infect., 2, 208–212, 2017
https://doi.org/10.7150/jbji.22443
© Author(s) 2017. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 2, 208–212, 2017
https://doi.org/10.7150/jbji.22443
© Author(s) 2017. This work is distributed under
the Creative Commons Attribution 4.0 License.

Original full-length article 13 Nov 2017

Original full-length article | 13 Nov 2017

Effect of Sonication on the Elution of Antibiotics from Polymethyl Methacrylate (PMMA)

Anne Kummer, Ulrika Furustrand Tafin, and Olivier Borens Anne Kummer et al.
  • University Hospital Lausanne (CHUV), Service of Orthopedics and Traumatology, University of Lausanne, Lausanne, Switzerland

Keywords: sonication, antibiotic elution, bone cement, polymethyl methacrylate, prosthetic joint infection

Abstract. Background: In the setting of prosthetic joint infections treated with a two-stage procedure, spacers can be sonicated after removal. We hypothesize that the sonication process may cause an increased elution of antibiotics from the spacer, leading to elevated concentrations of antibiotics in the sonication fluid inhibiting bacterial growth. We aimed to evaluate in vitro the influence of sonication on the elution of antibiotics from polymethyl methacrylate (PMMA) over time and to determine whether these concentrations are above the minimum inhibitory concentrations (MIC) for microorganisms relevant in prosthetic joint infections.

Methods: PMMA blocks impregnated with vancomycin, fosfomycin, gentamicin or daptomycin were incubated in phosphate-buffered saline (PBS) at 37°C for up to 6 weeks. PBS was changed once a week. Concentrations were determined from samples of each antibiotic every week, and after 5 minutes of sonication at 2, 4 and 6 weeks.

Results: With sonication there was a trend toward an increase of the elution of antibiotics. This increase was significant for vancomycin at 2 and 4 weeks (p=0.008 and 0.002 respectively) and for fosfomycin at 2 weeks (p=0.01).

Conclusion: The effect of sonication could play a role in clinical results, especially for daptomycin and gentamicin for which the MIC is close to the concentration of antibiotics at 4 and 6 weeks.

We conclude that elution of antibiotics from PMMA along with the effect of sonication could inhibit bacterial growth from spacers, resulting in false negative results in the setting of two-stage exchange procedures for prosthetic joint infections.

Publications Copernicus
Download
Citation