Oritavancin polymethylmethacrylate (PMMA)—compressive strength testing and in vitro elution
Abstract Background Polymethylmethacrylate (PMMA) is used for local antimicrobial delivery in orthopedic infection. Oritavancin is a long half-life lipoglycopeptide with broad activity against Gram-positive bacteria. Herein, we addressed if 7.5% w/w oritavancin mixed into PMMA affects PMMA strength...
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doaj-e00601f1548448299bc69e797e1998b22020-11-25T02:38:14ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-02-011411710.1186/s13018-019-1080-6Oritavancin polymethylmethacrylate (PMMA)—compressive strength testing and in vitro elutionSuzannah M. Schmidt-Malan0Kerryl E. Greenwood-Quaintance1Lawrence J. Berglund2Jayawant Mandrekar3Robin Patel4Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo ClinicDivision of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo ClinicMaterials Structural Testing Research Core, Mayo ClinicDivision of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo ClinicDivision of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo ClinicAbstract Background Polymethylmethacrylate (PMMA) is used for local antimicrobial delivery in orthopedic infection. Oritavancin is a long half-life lipoglycopeptide with broad activity against Gram-positive bacteria. Herein, we addressed if 7.5% w/w oritavancin mixed into PMMA affects PMMA strength and whether it elutes from PMMA, compared to vancomycin. Methods Elution was assessed by placing an oritavancin- or vancomycin-loaded bead in a flow system with human plasma. Compressive strength of bland compared to oritavancin- or vancomycin-loaded PMMA was assessed after 0, 3, and 7 days of soaking in 1 ml of pooled normal human plasma at 37 °C, by testing to failure in axial compression using a servo-hydraulic testing machine. Results Median compressive strength on days 0, 3, and 7 for bland PMMA compared to oritavancin- or vancomycin-loaded PMMA was 80.1, 79.4, and 72.4 MPa, respectively; 93.3, 86.4, and 65.3 MPa, respectively; and 97.8, 82.7, and 65.9 MPa, respectively. Oritavancin reduced PMMA compressive strength after 3 and 7 days (P = 0.0250 and 0.0039, respectively), whereas vancomycin reduced the PMMA compressive strength after 0, 3, and 7 days (P = 0.0039, 0.0039, and 0.0062, respectively) as compared to bland PMMA. Oritavancin-loaded PMMA had higher compressive strength than vancomycin-loaded PMMA on days 3 and 7 (P = 0.0039 and 0.0062, respectively). Compressive elastic moduli were 1226, 1299, and 1394 MPa for bland PMMA; 1253, 1078, and 1245 MPa for oritavancin-loaded PMMA; and 986, 879, and 779 MPa for vancomycin-loaded PMMA on days 0, 3 and 7, respectively. Oritavancin-loaded PMMA had higher compressive elastic moduli than vancomycin-loaded PMMA on days 0 and 7 (P = 0.0250 and 0.0062, respectively). Following polymerization, 1.0% and 51.9% of the initial amount of oritavancin and vancomycin were detected, respectively. C max, T max, and AUC0–24 were 1.7 μg/ml, 2 h, and 11.4 μg/ml for oritavancin and 21.4 μg/ml, 2 h, and 163.9 μg/ml for vancomycin, respectively. Conclusions Oritavancin-loaded PMMA had higher compressive strength than vancomycin-loaded PMMA on days 3 and 7 and higher compressive elastic moduli than vancomycin-loaded PMMA on days 0 and 7. However, proportionally less oritavancin than vancomycin eluted out of PMMA.http://link.springer.com/article/10.1186/s13018-019-1080-6OritavancinPolymethylmethacrylateElutionCompressive strength |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Suzannah M. Schmidt-Malan Kerryl E. Greenwood-Quaintance Lawrence J. Berglund Jayawant Mandrekar Robin Patel |
spellingShingle |
Suzannah M. Schmidt-Malan Kerryl E. Greenwood-Quaintance Lawrence J. Berglund Jayawant Mandrekar Robin Patel Oritavancin polymethylmethacrylate (PMMA)—compressive strength testing and in vitro elution Journal of Orthopaedic Surgery and Research Oritavancin Polymethylmethacrylate Elution Compressive strength |
author_facet |
Suzannah M. Schmidt-Malan Kerryl E. Greenwood-Quaintance Lawrence J. Berglund Jayawant Mandrekar Robin Patel |
author_sort |
Suzannah M. Schmidt-Malan |
title |
Oritavancin polymethylmethacrylate (PMMA)—compressive strength testing and in vitro elution |
title_short |
Oritavancin polymethylmethacrylate (PMMA)—compressive strength testing and in vitro elution |
title_full |
Oritavancin polymethylmethacrylate (PMMA)—compressive strength testing and in vitro elution |
title_fullStr |
Oritavancin polymethylmethacrylate (PMMA)—compressive strength testing and in vitro elution |
title_full_unstemmed |
Oritavancin polymethylmethacrylate (PMMA)—compressive strength testing and in vitro elution |
title_sort |
oritavancin polymethylmethacrylate (pmma)—compressive strength testing and in vitro elution |
publisher |
BMC |
series |
Journal of Orthopaedic Surgery and Research |
issn |
1749-799X |
publishDate |
2019-02-01 |
description |
Abstract Background Polymethylmethacrylate (PMMA) is used for local antimicrobial delivery in orthopedic infection. Oritavancin is a long half-life lipoglycopeptide with broad activity against Gram-positive bacteria. Herein, we addressed if 7.5% w/w oritavancin mixed into PMMA affects PMMA strength and whether it elutes from PMMA, compared to vancomycin. Methods Elution was assessed by placing an oritavancin- or vancomycin-loaded bead in a flow system with human plasma. Compressive strength of bland compared to oritavancin- or vancomycin-loaded PMMA was assessed after 0, 3, and 7 days of soaking in 1 ml of pooled normal human plasma at 37 °C, by testing to failure in axial compression using a servo-hydraulic testing machine. Results Median compressive strength on days 0, 3, and 7 for bland PMMA compared to oritavancin- or vancomycin-loaded PMMA was 80.1, 79.4, and 72.4 MPa, respectively; 93.3, 86.4, and 65.3 MPa, respectively; and 97.8, 82.7, and 65.9 MPa, respectively. Oritavancin reduced PMMA compressive strength after 3 and 7 days (P = 0.0250 and 0.0039, respectively), whereas vancomycin reduced the PMMA compressive strength after 0, 3, and 7 days (P = 0.0039, 0.0039, and 0.0062, respectively) as compared to bland PMMA. Oritavancin-loaded PMMA had higher compressive strength than vancomycin-loaded PMMA on days 3 and 7 (P = 0.0039 and 0.0062, respectively). Compressive elastic moduli were 1226, 1299, and 1394 MPa for bland PMMA; 1253, 1078, and 1245 MPa for oritavancin-loaded PMMA; and 986, 879, and 779 MPa for vancomycin-loaded PMMA on days 0, 3 and 7, respectively. Oritavancin-loaded PMMA had higher compressive elastic moduli than vancomycin-loaded PMMA on days 0 and 7 (P = 0.0250 and 0.0062, respectively). Following polymerization, 1.0% and 51.9% of the initial amount of oritavancin and vancomycin were detected, respectively. C max, T max, and AUC0–24 were 1.7 μg/ml, 2 h, and 11.4 μg/ml for oritavancin and 21.4 μg/ml, 2 h, and 163.9 μg/ml for vancomycin, respectively. Conclusions Oritavancin-loaded PMMA had higher compressive strength than vancomycin-loaded PMMA on days 3 and 7 and higher compressive elastic moduli than vancomycin-loaded PMMA on days 0 and 7. However, proportionally less oritavancin than vancomycin eluted out of PMMA. |
topic |
Oritavancin Polymethylmethacrylate Elution Compressive strength |
url |
http://link.springer.com/article/10.1186/s13018-019-1080-6 |
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