When mixed into a carrier; vancomycin, tobramycin and gentamicin can retain their potencies, releasing their antibiotics for up to 40 days. The one caveat in the news, is that the carrier must have the ability to release antibiotics in such a sustained fashion.
Antibiotic Potency Lasts up to 40 Days: New Study
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#periprostheticjointinfectionSecondary#pseudomonasaeruginosa#staphylococcusaureus
The study, titled, “Comparisons for the efficacy of synthetic bone void fillers for antimicrobial potency and the prevention and killing efficacy of bacterial biofilms: An In-Vitro Study,” was presented by author Paul Stoodley, PhD, Director, Campus Microscopy and Imaging Facility, Professor, Departments of Microbial Infection and Immunity and Orthopedics, Infectious Diseases Institute, The Ohio State University at the recently concluded AAOS Annual Meeting.
Antibiotic resistant bacteria are one of the great bogeymen of orthopedic surgery. OTW spoke with the manufacturer of STIMULAN®, UK based Biocomposites about the study and STIMULAN®, which was the product tested in the study.
According to Biocomposites, STIMULAN®, is a calcium bone graft substitute which is designed to be mixed with antibiotics as a method for treating bacterial infection in soft tissue surrounding bone.
Michael Harris, CEO of Biocomposites, commented on both the study and STIMULAN® saying, “This in-vitro study demonstrated that vancomycin, tobramycin and gentamicin retain potency when mixed and set with genex and releases antibiotics over periods of up to 40 days. It showed similar efficacy as STIMULAN® in both the prevention and significantly reducing the bioburden against two pathogens (Pseudomonas aeruginosa and Staphylococcus aureus) common to periprosthetic infection and fracture-related infection.”
“In the last year we have received European approval for mixing STIMULAN® with antibiotics: vancomycin, gentamicin and tobramycin, for use in infected bone and soft tissue, and Canadian approval for use in treating bacterial infection in soft tissue surrounding bone, making it the first and only approved calcium matrix that can carry an antibiotic to treat bacterial infection.”
“Biocomposites also launched STIMULAN® Rapid Cure 3cc product in the U.S., designed specifically for smaller voids in foot and ankle, orthopaedic reconstruction and trauma procedures. Our genex bone graft substitute product is a truly absorbable bone void filler for use in trauma and is gaining good traction in the U.S.”
“The global increase in infections caused by antibiotic resistant bacteria has required more targeted antibiotic treatment and the flexibility for surgeons managing infection to use their chosen antibiotics at patient-specific concentration levels. Biocomposites provide a unique tailored solution to these issues with our STIMULAN® product, a calcium sulfate antibiotic carrier.”
“Our products are used in over 50,000 procedures every year. Going forward we aim to see growing adoption of STIMULAN® and genex by surgeons beyond our traditional focus of trauma and orthopaedics and into spine and foot and ankle…And play our part in tackling the global challenge of antimicrobial resistance.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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