Platelet-rich plasma (PRP) as a local delivery system for antibiotics in bone infections: an in vitro study
Keywords:
Platelet-Rich Plasma, Antibacterial Agents, In VitroAbstract
Introduction: Currently polymethylmethacrylate is the most commonly used vehicle for antibiotic local delivery, approved by FDA. Current data have demonstrated that the use of this system has improved the outcome on patients beneath treatment of infection associated or caused by orthopedic implants, mainly because of its ability to achieve very high local concentrations of antibiotic without associated systemic toxicity. Nevertheless, it is also a concern that sometimes PMMA may act as a foreign body within our body, once it has completed its antibiotic release, and specially, once the antibiotic release rate has dropped below therapeutic levels. Perhaps, sometimes PMMA could even act as a friendly surface for bacterial biofilm.
Methods: A standardized controlled in-vitro study was designed following the agar diffusion method, according to parameters set by Clinical and Laboratory Standards Institute (CLSI) in 2007, in order to determine if the platelet rich plasma (PRP) loaded with antibiotic could work as a carrier and as an antibiotic local delivery system, by inhibiting a known S. aureus subtype growth.
Results: All antibiotics tested were transported and released by the PRP. We find out a direct relationship between bacterial inhibition halos and antibiotic concentration dilutions. As higher the concentration as bigger the halo. Oxacilin at 1:32 dilution had a bacterial inhibition halo even greater than the sensidisc. The bacterial inhibition halos produced by the Vancomycin were the smaller ones. Ciprofloxacin shown the lowest bacterial inhibition capacity compared to control.
Discussion: PRP has the ability to perform as an antibiotic carrier as well as a local antibiotic delivery system in-vitro. Due to the heterogeneous behavior shown in these different antibiotic trials, it is assumed that each antibiotic has its own diffusion capacity which must be taken in consideration any time the PRP wants to be used as a local antibiotic delivery system.
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