Antimicrobial Distribution From Local Delivery Depends on Dose: A Pilot Study With MRI

Alex McLaren, Morgan B. Giers, James Fraser, Luke Hosack, Michael Caplan, Ryan McLemore

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Tissue distribution after local delivery has been quantified over a period of 5 hours on 7-T MRI in a rabbit model using gadolinium-labeled diethylenetriamine pentaacetic acid (Gd-DTPA) as an antimicrobial surrogate; however, it is unknown how the Gd-DTPA load in a local depot will affect the duration of high-concentration Gd-DTPA in local tissues after surgical débridement.

Questions/purposes: We determined whether the Gd-DTPA load in bone cement affected its local tissue distribution over a period of 1 month after local delivery.

Methods: A 1-cm 3 soft tissue dead space was created in the quadriceps of seven rabbits and filled with gadolinium-loaded bone cement. At 7, 14, and 33 days, the volume of tissue with a Gd-DTPA concentration of more than 14 μg/mL was calculated from T1-weighted images using 7-T MRI. Differences in volumes of distribution were analyzed with ANOVA.

Results: The volume of tissue with more than 14 μg/mL Gd-DTPA was much larger from higher gadolinium loads on Day 7 (p = 0.02) (2121 mm 3 for 10 g and 665 mm 3 for 1 g) and smaller with time for the 10-g formulation (2121 mm 3 on Day 7 and 1241 mm 3 on Day 14).

Conclusions: Volume of distribution and duration of Gd-DTPA after local delivery increased with increasing load in the cement and decreased with time.

Clinical Relevance: For local delivery, high antimicrobial concentrations would be expected in greater volumes of tissue, for longer durations, when higher antimicrobial loads are used.

Original languageEnglish (US)
Pages (from-to)3324-3329
Number of pages6
JournalClinical Orthopaedics and Related Research
Volume472
Issue number11
DOIs
StatePublished - Oct 2 2014

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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