Experimental study of calcium phosphate cement impregnated with dideoxy-kanamycin B.

Background: The present study was undertaken to examine whether antibiotic-impregnated calcium phosphate cement (CPC) would provide a valid means of treating osteomyelitis.
Methods: The antibiotic used for the impregnation was dideoxy-kanamycin B (DKB), which is available in two forms (powder and liquid). Columnar test specimens (diameter 7 mm, height 14 mm) were prepared by adding the liquid or powdered DKB. Group A: Three types (6.25-titer, 12.5-titer, 25-titer) of test specimen were prepared by mixing the setting solution and DKB solutions into cement. Group B: Three types (25-titer, 50-titer, 100-titer) of test specimen were prepared by mixing the setting solution and DKB powder into cement. Group C: A control specimen was prepared by mixing the setting solution into the cement. The study included a consistency test, setting-time test, compressive strength test, porosity test, and elution test.
Results: The value for the consistency test was >23 mm in all test groups. The results of the setting-time test showed that the setting time became significantly longer as the DKB content increased for groups A group B. Compressive strength decreased as the antibiotic content increased, although all specimens remained sufficiently strong for clinical application. In group A the porosity did not differ significantly depending on the antibiotic content, whereas in group B the porosity increased significantly as the antibiotic content increased. In the elution test using specimens with the same titer (25 titer), the elution efficiency was higher in group A than in group B, and the duration of elution was longer in group A.
Conclusions: Although polymethylmethacrylate (PMMA) has been conventionally used as a drug-delivery system (DDS), the results of the present study indicate that CPC shows better elution efficiency than PMMA. It is thus a promising DDS for the treatment of osteomyelitis.