Incorporation of Antibiotics Effective Against Multidrug Resistant Pathogens Into PMMA for Cranio-Maxillofacial Implants
Technical Report,01 Mar 2015,31 May 2016
Naval Medical Research Unit Fort Sam Houston United States
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The rise in incidence of infections caused by multidrug-resistant MDR pathogens such as Staphylococcus aureus presents a problem in the treatment of post-surgical infections at cranio-maxillofacial implant sites. Incorporation of antibiotics against MOR pathogens into polymethyl methacrylate PMMA is a potential treatment to reduce infections. The objective of this study was to evaluate the structural, mechanical, and antimicrobial activity of PMMA incorporated with colistin, polymyxin B, or minocycline against Gram-positive S. aureus and Gram-negative A. baumanniii. Two ratios of antibiotic 0.5g40 mL and 1.0g,40 mL were incorporated into PMMA test rods. All three antibiotics were successfully incorporated into PMMA at ratios of 0.5g and 1.0g of antibiotics. The addition of the antibiotics and immersion in water for 30 days did not significantly affect the structural or mechanical properties of the polymer. Each antibiotic exhibited a burst release profile, except for minocycline at 1.0g which showed a sustained release profile. However, addition of colistin at any concentration and of minocycline at higher concentrations may not be preferred for sustained release because the heterotrophic resistance properties of certain bacterial strains in response to these antibiotics may lead to adverse nosocomial infections.