Elution of vancomycin and meropenem and their combinations from various bone cement materials

Introduction Saturation of bone defect filling materials with antibacterial agents is used for the treatment of patients with infectious bone complications and for their prevention.The purpose of the work was to evaluate the elution rate of vancomycin and meropenem from bone cements based on polymethyl methacrylate and polyurethane polymers impregnated into the material in their combination.Materials and methods In an in vitro study, a comparative analysis of the kinetics of vancomycin and meropenem release from two materials was performed that were based on polyurethane polymers (PU series) and polymethyl methacrylate (PMMA series). Antibiotics were added to the materials before their polymerization in the following proportions: group 1 - polymer : antibiotic 10 g : 1 g (0.5 g vancomycin + 0.5 g meropenem); group 2 - polymer : antibiotic 10 g : 0.5 g (0.25 g vancomycin + 0.25 g meropenem). Samples loaded with one antibiotic were used as a control: group 1v - polymer : antibiotic 10 g : vancomycin 0.5 g; group 1m - polymer : antibiotic 10 g : meropenem 0.5 g; group 2v - polymer: antibiotic 10 g: vancomycin 0.25 g; group 2m - polymer: antibiotic 10 g: meropenem 0.25 g.Results Vancomycin elution from both PMMA- and PU-based materials loaded with a vancomycin+meropenem was greater in final volume and longer in time than from materials containing vancomycin alone. Conversely, meropenem release from PMMA and PU loaded with a vancomycin + meropenem mixture was less in volume than from the materials containing meropenem alone.Discussion The use of a vancomycin-meropenem complex in bone cements reveals the following feature: meropenem promotes the release of vancomycin from the studied materials, while the elution of meropenem itself is reduced.Conclusion Combining antibiotics for impregnation into materials for bone defect filling has an impact on the kinetics of antibiotics release, unlike the release kinetics of an antibiotic loaded into the material as monotherapy.