Journal
BIOMATERIALS
Volume 24, Issue 10, Pages 1829-1831Publisher
ELSEVIER SCI LTD
DOI: 10.1016/S0142-9612(02)00614-2
Keywords
polymethylmethacryate; beads; gentamicin; biodegradable; antibiotic resistance
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In infected joint arthroplasty, high local levels of antibiotics are achieved through temporary implantation of non-biodegradable gentamicin-loaded polymethylmethacrylate beads. Despite their antibiotic release, these beads act as a biomaterial surface to which bacteria preferentially adhere, grow and potentially develop antibiotic resistance. In routine clinical practice, these beads are removed after 14 days, but for a variety of reasons, we were confronted with a patient in which these beads were left in situ for 5 years. Retrieval of gentamicin-loaded beads from this patient constituted an exceptional case to study the effects of long-term implantation on potentially colonizing microflora and gentamicin release. Gentamicin-release test revealed residual antibiotic release after being 5 years in situ and extensive microbiological sampling resulted in recovery of a gentamicin-resistant staphylococcal strain from the bead surface. This case emphasizes the importance of developing biodegradable antibiotic-loaded beads Lis an antibiotic delivery system. (C) 2003 Elsevier Science Ltd. All rights reserved.
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