Research into biocompatibility and cytotoxicity of daptomycin, gentamicin, vancomycin and teicoplanin antibiotics at common doses added to bone cement
Seyran Kılınç1, Tutku Tunç2, Özhan Pazarcı1, Zeynep Sümer3
1Department of Orthopedics and Traumatology, Cumhuriyet University School of Medicine, Sivas, Turkey
2Department of Pharmaceutical Sciences/Pharmaceutical Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
3Department of Microbiology, Cumhuriyet University School of Medicine, Sivas, Turkey
Keywords: Antibiotics, biocompatibility, bone cement, cytotoxicity, polymethylmethacrylate
Abstract
Objectives: This study aims to investigate the biocompatibility and cytotoxicity of daptomycin, gentamicin, vancomycin and teicoplanin at commonly-used dose intervals added to polymethylmethacrylate (PMMA) in vitro.
Materials and methods: This prospective study was conducted between February 2016 and June 2016. Antibiotics were added to PMMA at doses frequently used in clinical practice. The antibiotic doses added were teicoplanin (2 g, 3 g, 4 g), gentamicin (0.5 g, 0.75 g, 1 g), daptomycin (0.5 g.) and vancomycin (2 g, 3 g, 4 g). Standard cement balls (10 mm) were created. Activated L929 mouse fibroblast cell culture was used for incubation. Agar diffusion, Cell Proliferation Kit II (XTT) test and electron microscope investigations were performed to examine biocompatibility and cytotoxicity.
Results: In the cytotoxicity test, teicoplanin at 4 g and daptomycin at 0.5 g doses were observed to cause reductions in viability percentages. The same doses caused 20% and 20-40% cell lysis indices during the agar diffusion test. On electron microscope images, cytotoxic effects in fibroblast cells and involvement with the surface of cement balls were observed.
Conclusion: Gentamicin, vancomycin and teicoplanin were observed to be non-toxic and biocompatible at commonly-used dose intervals. Teicoplanin at 4 g and daptomycin at 0.5 g doses were identified to be cytotoxic and not biocompatible. When selecting antibiotics to be added to bone cement, care should be taken that the antibiotic is non-toxic and biocompatible.
Citation: Kılınç S, Tunç T, Pazarcı Ö, Sümer Z. Research into biocompatibility and cytotoxicity of daptomycin, gentamicin, vancomycin and teicoplanin antibiotics at common doses added to bone cement. Jt Dis Relat Surg 2020;31(2):328-334.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The authors are grateful for the contribution of Dr. Ali Özer and Sivas Cumhuriyet University, R&D Center, SEM Facility Lab. (CUTAM) in the evaluation of the SEM images.