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Antimicrobial efficacy and activity perseverance in arthroplasty of calcium sulfate beads containing vancomycin prepared ahead of time and stored in ready-to-use formula

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Abstract

The use of local therapy with antibiotics in a suitable carrier is essential in the treatment and prevention of infections in orthopedic surgery and traumatology. In our orthopedic surgery department, a synthetic calcium sulfate hemihydrate (CaSO4·½H2O) is used as an antibiotic carrier, enabling the application of most types of intravenous antibiotics in the form of powder and liquid. This type of carrier with antibiotics is prepared in the theater during the procedure. During a surgical procedure, a small dead space is created (hand and foot area), which must be filled with an antibiotic carrier, and the situations arise where a large amount of the carrier is not used and thrown away. Therefore, we verified the efficacy of vancomycin in the pre-prepared carrier by an orientation microbiological method and by measuring the concentrations of the vancomycin released in active form and its two crystalline degradation products. Based on the agar diffusion test, we did not measure any difference in the effectiveness of the antibiotic in the carrier after its 12-day storage. Although vancomycin concentrations decreased by approximately 32% at the end of 12 days of storage, the concentrations of the released active form of vancomycin are many times higher than the minimum inhibitory concentrations for resistant strains of Staphylococcus aureus. Thus, the calcium sulfate carrier with vancomycin can be prepared several days in advance before its application, certainly up to 12 days.

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Acknowledgements

Supported by Ministry of Health, Czech Republic—conceptual development of research organization, University Hospital Motol, Prague, Czech Republic 00064203. Special thanks to Dr. John Wilson for English language revision.

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Authors and Affiliations

  1. Department of Orthopedics, First Faculty of Medicine, University Hospital Motol, Charles University, V Úvalu 84, 150 06, Prague 5, Czech Republic

    P. Melicherčík, I. Landor & D. Jahoda

  2. Department of Medical Chemistry and Clinical Biochemistry, Second Faculty of Medicine, University Hospital Motol, Charles University, V Úvalu 84, 150 06, Prague, Czech Republic

    E. Klapková, K. Kotaška & M. Neščáková

  3. Department of Medical Microbiology, Second Faculty of Medicine, University Hospital Motol, Charles University, V Úvalu 84, 150 06, Prague, Czech Republic

    O. Nyč

  4. Department of Internal Medicine, Second Faculty of Medicine, University Hospital Motol, Charles University, V Úvalu 84, 150 06, Prague, Czech Republic

    M. Neščáková

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  1. P. Melicherčík
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  2. E. Klapková
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Correspondence to E. Klapková.

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Melicherčík, P., Klapková, E., Nyč, O. et al. Antimicrobial efficacy and activity perseverance in arthroplasty of calcium sulfate beads containing vancomycin prepared ahead of time and stored in ready-to-use formula. Folia Microbiol 67, 63–69 (2022). https://doi.org/10.1007/s12223-021-00916-7

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  • DOI: https://doi.org/10.1007/s12223-021-00916-7

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