Effects of cefuroxime on human osteoblasts in vitro.
ABSTRACT The local application of antibiotics in bone cement achieves high local effective antibiotic concentrations. Cefuroxime is widely used for antibiotic prophylaxis in orthopedic surgery, and several reports highlighted a beneficial outcome if cefuroxime-impregnated bone cement was used, but there is a lack of information of direct cefuroxime effects on human bone cells. We, therefore, cultured osteoblasts, previously derived from human trabecular bone specimens and used as a cell-pool further on, with different concentrations of cefuroxime (0-1000 microg/mL) for 24, 48, or 72 h. For reversibility testing, osteoblasts were cultivated for 24 h with cefuroxime followed by 48 h without antibiotics. Cell proliferation (MTT), cytotoxicity (lactate dehydrogenase (LDH)-activity), cell metabolism (alkaline phosphatase (ALP)-activity), and extracellular matrix calcification (Alizarin staining) were assessed after antibiotic treatment. Cefuroxime concentrations of 25-100 microg/mL had little or no effect on cellular proliferation. Proliferation was significantly stimulated at 250 and 1000 microg/mL at each time. LDH-activity significantly increased at the highest concentration of 1000 microg/mL at 72 h. ALP-activity first increased at lower concentrations and then significantly decreased at 1000 microg/mL at 48 and 72 h. Similar to ALP-activity, calcification increased at lower concentrations and was not detectable at 1000 microg/mL. All revealed effects at 24 h were at least partially reversible. In the present study, we demonstrated that cefuroxime at lower concentrations had no inhibiting effects on human osteoblasts. In contrast, higher concentrations significantly altered osteoblastic function. When administered locally in total joint arthroplasty, for example, in antibiotic-impregnated bone cement, cefuroxime might critically impair osteoblastic function and periprosthetic bone metabolism.
- SourceAvailable from: Nai-Jen Chang[Show abstract] [Hide abstract]
ABSTRACT: Suffering from post-arthroplasty infection is a devastating complication. Local antibiotic treatment in revision surgery is a potential therapeutic strategy to avert the recurrence of infection. The purposes of this study were to study whether double-layer poly(lactic-co-glycolic acid) (PLGA) encapsulated cefuroxime-loaded titanium (Ti) alloy pins would extend the duration of steady antibiotic release in vitro and then investigate the self-anti-infection ability on an in vivo Staphylococcus aureus induced osteomyelitis rat model. The concentration of antibiotic release was quantified with an in vitro elution test by spectrophotometer. The agar diffusion test was to confirm the efficacy of the antibiotic used. The in vivo anti-infection investigation included osteomyelitis rat model induced by Staphylococcus aureus injection into femur (SA group) and implanting naked titanium pin (SA+Ti group) or PLGA encapsulated cefuroxime loaded titanium pin (SA+Ti/PLGA group). The main outcomes were characterized by micro-CT images and histological observation in 1, 4, and 7 weeks after operation. The elution test results revealed the effective antibiotic release durations could be up to 17 days for double layer PLGA encapsulating antibiotic loaded titanium pin. At 7 weeks of the in vivo experiments, the S.A+Ti group had the most severe intramedullary abscess, infection, inflammatory cells, necrotic bone, bone lucency and sequestrum shown; however, S.A+Ti/PLGA group had the modest. In conclusions, this biodegradable double-layer PLGA/cefuroxime encapsulation was able to extend antibiotic release beyond 17 days. Also, the double-layer PLGA/cefuroxime encapsulations approach could be an efficient strategy in long-term antibiotic treatment for osteomyelitis and potential clinical application.Journal of Medical and Biological Engineering · 1.08 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Autogenous cancellous bone graft provides an osteoconductive, osteoinductive, and osteogenic substrate for filling bone voids and augmenting fracture-healing.The iliac crest remains the most frequently used site for bone-graft harvest, but the proximal part of the tibia, distal end of the radius, distal aspect of the tibia, and greater trochanter are alternative donor sites that are particularly useful for bone-grafting in the ipsilateral extremity.The most common complication associated with the harvest of autogenous bone graft is pain at the donor site, with less frequent complications including nerve injury, hematoma, infection, and fracture at the donor site.Induced membranes is a method that uses a temporary polymethylmethacrylate cement spacer to create a bone-graft-friendly environment to facilitate graft incorporation, even in large segmental defects.The Journal of Bone and Joint Surgery 12/2011; 93(23):2227-36. · 4.31 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To investigate the bioequivalence and the population pharmacokinetics of cefuroxime lysine and cefuroxime sodium in healthy beagle dogs. A randomized 2-period crossover design in 18 healthy beagle dogs after receiving 20, 40, and 80 mg/kg of cefuroxime lysine or cefuroxime sodium was conducted. A 3-compartment open model was used as the basic model for the population pharmacokinetic study. Both of the antibiotics exhibited dose-proportional pharmacokinetics over the dose range of 20-80 mg/kg. The mean relative bioavailability of cefuroxime lysine versus cefuroxime sodium was 1.05 (range, 0.71 to 1.42), with a significant difference between males and females. The estimates of population pharmacokinetic of CL, V(1), Q(2), V(2), Q(3), V(3) were 3.74 mL/h, 1.70 mL, 29.5 mL/min, 3.58 mL, 0.31 mL/min, and 158 mL for cefuroxime lysine and 4.10 mL/h, 1.00 mL, 38.5 mL/min, 4.19 mL, 0.06 mL/min, and 13.6 mL for cefuroxime sodium, respectively. The inter-individual variability was determined to be less than 29.1%. A linear pharmacokinetic was revealed for cefuroxime lysine and cefuroxime sodium in dogs after intravenous infusion, and the bioequivalence of these forms of the antibiotic was observed with the significant gender-related differences in mean relative bioavailability of cefuroxime lysine versus cefuroxime sodium.BioMed Research International 01/2012; 2012:507294. · 2.71 Impact Factor