Systemic versus Free Antibiotic Delivery in Preventing Acute Exogenous Implant Related Infection in a Rat Model

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  • Scott Marston, University of Minnesota
  • ,
  • Gudrun Mirick Mueller, Hennepin Healthcare Research Institute
  • ,
  • Arick Sabin, Hennepin Healthcare Research Institute
  • ,
  • Glen T Hansen, University of Minnesota
  • ,
  • Bruce Lindgren, University of Minnesota
  • ,
  • Conrado Aparicio, University of Minnesota
  • ,
  • Alexandra R Armstrong, University of Minnesota
  • ,
  • Ole Halfdan Larsen
  • Andrew Schmidt, University of Minnesota
  • ,
  • Richard Kyle, University of Minnesota
  • ,
  • Ramon Gustilo, University of Minnesota
  • ,
  • Dean Tsukayama, University of Minnesota
  • ,
  • Joan Bechtold, University of Minnesota
  • ,
  • Mats Bue

We studied systemic ceftriaxone, and free/local tobramycin and doxycycline in a controlled rat model representing a generic acute exogenous joint infection. We hypothesized that evidence of infection (quantitative colony forming units [CFU], qualitative scanning electron microscopy [SEM], histopathology) (1a) would be reduced with local versus 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. Study groups included infected and noninfected (1) control (no treatment), (2) systemic ceftriaxone (daily), (3) local tobramycin, and (4) local doxycycline (10 rats/group; power = 0.8). With IACUC approval, a reliable acute exogenous joint infection was created by slowly injecting 50-μl, 10 4 CFU Staphylococcus aureus, into the distal femoral medullary canal. The antibiotic formulation was introduced locally to the femoral canal and joint space. 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 the surface of the pin, histopathology identified tissue response, liquid chromatography/mass spectrometry quantified plasma antibiotic. (1) Groups receiving any antibiotic reported lower CFU/ml in synovium compared with no treatment. (2) In the synovium, free/local tobramycin reduced CFU/ml to a greater extent than free/local doxycycline (p < 0.05). (3) Antibiotic in plasma after the local application was nondetectable in all groups after 4 weeks. SEM revealed no difference in biofilm on pin among all groups.

OriginalsprogEngelsk
TidsskriftJournal of Orthopaedic Research
Vol/bind40
Nummer2
Sider (fra-til)429-438
Antal sider10
ISSN0736-0266
DOI
StatusUdgivet - feb. 2022

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