Ceftaroline fosamil laden allograft: A new modality in reducing infection?

Purpose: Allograft infection remains the greatest challenge in orthopaedic reconstructive surgery especially methicillin-resistant Staphylococcus aureus (MRSA). This risk can be minimized with the use of antibiotic laden allograft (ALA) via iontophoresis. Ceftaroline fosamil (CF) is an advanced-gene...

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Main Authors: Singh, Vivek Ajit, Lim, Han Sim, Haseeb, Amber, Teh, Cindy Shuan Ju
Format: Article
Published: SAGE Publications 2018
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Online Access:http://eprints.um.edu.my/20648/
https://doi.org/10.1177/2309499018806671
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spelling my.um.eprints.206482019-03-11T08:27:15Z http://eprints.um.edu.my/20648/ Ceftaroline fosamil laden allograft: A new modality in reducing infection? Singh, Vivek Ajit Lim, Han Sim Haseeb, Amber Teh, Cindy Shuan Ju R Medicine Purpose: Allograft infection remains the greatest challenge in orthopaedic reconstructive surgery especially methicillin-resistant Staphylococcus aureus (MRSA). This risk can be minimized with the use of antibiotic laden allograft (ALA) via iontophoresis. Ceftaroline fosamil (CF) is an advanced-generation cephalosporin, an alternative treatment for MRSA infections. Its antibacterial activity and safety profile are better than vancomycin. CF iontophoresed bone has not been used before. This study was conducted to establish the feasibility of creating a CF ALA and establish the prime conditions for its expenditure. Method: We created an iontophoresis cell; 3% CF was inserted within medullary segment of goat bone and sealed from external saline solution. The cell operated at the following voltages 30, 60 and 90 V and at the following durations 5, 10, 15, 20, 25 and 30 min. Information regarding optimal conditions for its application was then obtained. After which, correlation between voltages and time with CF concentration in the bone was analysed. A bioavailability test was also conducted to observe the optimal rate of CF elution from the graft. Result: The optimal condition for the impregnation process is 3% CF at 90 V for 10 min. Bone graft impregnated with CF at optimal conditions can elute above minimum inhibitory concentration of the CF against MRSA for 21 days. Conclusion: CF iontophoresis was found feasible for allograft impregnation. The technique is simple, inexpensive and reproducible clinically. Iontophoresis offers a novel solution to reduce the rate of perioperative infection in reconstructive surgery involving use of bone graft. SAGE Publications 2018 Article PeerReviewed Singh, Vivek Ajit and Lim, Han Sim and Haseeb, Amber and Teh, Cindy Shuan Ju (2018) Ceftaroline fosamil laden allograft: A new modality in reducing infection? Journal of Orthopaedic Surgery, 26 (3). p. 230949901880667. ISSN 2309-4990 https://doi.org/10.1177/2309499018806671 doi:10.1177/2309499018806671
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Singh, Vivek Ajit
Lim, Han Sim
Haseeb, Amber
Teh, Cindy Shuan Ju
Ceftaroline fosamil laden allograft: A new modality in reducing infection?
description Purpose: Allograft infection remains the greatest challenge in orthopaedic reconstructive surgery especially methicillin-resistant Staphylococcus aureus (MRSA). This risk can be minimized with the use of antibiotic laden allograft (ALA) via iontophoresis. Ceftaroline fosamil (CF) is an advanced-generation cephalosporin, an alternative treatment for MRSA infections. Its antibacterial activity and safety profile are better than vancomycin. CF iontophoresed bone has not been used before. This study was conducted to establish the feasibility of creating a CF ALA and establish the prime conditions for its expenditure. Method: We created an iontophoresis cell; 3% CF was inserted within medullary segment of goat bone and sealed from external saline solution. The cell operated at the following voltages 30, 60 and 90 V and at the following durations 5, 10, 15, 20, 25 and 30 min. Information regarding optimal conditions for its application was then obtained. After which, correlation between voltages and time with CF concentration in the bone was analysed. A bioavailability test was also conducted to observe the optimal rate of CF elution from the graft. Result: The optimal condition for the impregnation process is 3% CF at 90 V for 10 min. Bone graft impregnated with CF at optimal conditions can elute above minimum inhibitory concentration of the CF against MRSA for 21 days. Conclusion: CF iontophoresis was found feasible for allograft impregnation. The technique is simple, inexpensive and reproducible clinically. Iontophoresis offers a novel solution to reduce the rate of perioperative infection in reconstructive surgery involving use of bone graft.
format Article
author Singh, Vivek Ajit
Lim, Han Sim
Haseeb, Amber
Teh, Cindy Shuan Ju
author_facet Singh, Vivek Ajit
Lim, Han Sim
Haseeb, Amber
Teh, Cindy Shuan Ju
author_sort Singh, Vivek Ajit
title Ceftaroline fosamil laden allograft: A new modality in reducing infection?
title_short Ceftaroline fosamil laden allograft: A new modality in reducing infection?
title_full Ceftaroline fosamil laden allograft: A new modality in reducing infection?
title_fullStr Ceftaroline fosamil laden allograft: A new modality in reducing infection?
title_full_unstemmed Ceftaroline fosamil laden allograft: A new modality in reducing infection?
title_sort ceftaroline fosamil laden allograft: a new modality in reducing infection?
publisher SAGE Publications
publishDate 2018
url http://eprints.um.edu.my/20648/
https://doi.org/10.1177/2309499018806671
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score 13.211869