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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_12 | Pages 58 - 58
1 Oct 2019
SYSTEMIC AND FREE LOCAL ANTIBIOTIC DELIVERY METHOD TO PREVENT IMPLANT-RELATED INFECTION
Mirick GM Sabin A Hansen G Lindgren B Aparicio C Carlson CS Bue M Larsen O Schmidt AH Kyle R Gustilo RB Tsukayama D Bechtold JE
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Introduction

We studied free (= local powder) tobramycin and doxycycline, and controlled release (= local lipid bilayer) doxycycline formulations in a rat model representing a generic joint infection. We hypothesized that evidence of infection (quantitative colony forming units (CFU), qualitative SEM, histopathology) (1a) would be reduced with local vs. systemic antibiotic, (1b) any antibiotic would be superior to control (2) there would be a difference among antibiotics, and (3) antibiotic would not be detectable in serum at 4-week euthanasia.

Methods

Study groups included infected and non-infected (1) control, (2) systemic ceftriaxone (daily), (3) local tobramycin, (4) local doxycycline and (5) controlled release doxycycline. With IACUC approval, (10 rats/group; power =0.8), 50-μl, 10×4 CFU Staphylococcus aureus, slowly injecting into distal femoral medullary canal, reliably created joint infection. Antibiotic formulation was introduced locally into cavity and joint, pin was inserted, and tissues closed. After 4-weeks, serum, pin, bone and synovium were obtained. CFU/ml of bone and synovium were quantified using macrotiter method. SEM imaged biofilm on surface of pin, histopathology identified tissue response, liquid chromatography/mass spectrometry measured plasma antibiotic. Kruskal-Wallis one-way ANOVA compared groups.