gms | German Medical Science

Joint German Congress of Orthopaedics and Trauma Surgery

02. - 06.10.2006, Berlin

Effects of cefuroxime and clindamycin on osteoblastic function in vitro

Meeting Abstract

  • G.M. Salzmann - Abteilung für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • F.D. Naal - Abteilung für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • J. Schauwecker - Abteilung für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • J. Tübel - Abteilung für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • R. Gradinger - Abteilung für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • A.B. Imhoff - Abteilung für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 92. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 47. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 02.-06.10.2006. Düsseldorf, Köln: German Medical Science; 2006. DocE.4.1-574

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgu2006/06dgu0104.shtml

Published: September 28, 2006

© 2006 Salzmann et al.
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Outline

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Introduction: In orthopaedic surgery the antibiotics Cefuroxime and Clindamycin are routinely applied systemically and locally for perioperative prophylaxis and for the treatment of prosthetic joint infections or chronic osteomyelitis. This experimental study was conducted to investigate their effects on osteoblastic function.

Materials and methods:In vitro, human osteoblasts were exposed to the concentrations 25, 50, 100, 250 and 1000µg/ml of Cefuroxime and 10, 25, 50, 100 and 500µg/ml of Clindamycin. 24, 48 and 72 hours after exposure measurements for MTT (Dimethylthiazol-Diphenyltetrazoliumbromid) as a marker for proliferation, LDH (lactadehydrogensae) as a marker for toxicity and AP (alkaline phosphatase) as a marker for metabolism were performed respectively. To simulate perioperative prophylaxis cells were exposed to Cefuroxime for 24 hours whereupon they were cultured antibiotic-free for another 48 hours. Furthermore a calcification measurement was performed for both antibiotics to investigate on the differentiation behavior of cultured cells. Measured parameters were expressed as a percentage of values obtained using untreated cells and demonstrated as the mean ± standard deviation (SD). Differences were considered to be significant when p ≤ 0.05 using the Student“s unpaired t test.

Results: Cefuroxime concentrations up to 100µg/ml showed no effect on proliferation while at 250 and 1000µg/ml a time-and dose dependent increase could be detected, which was up to 200% at each time at 1000µg/ml. Up to 250µg/ml no increase in LDH activity could be detected at any time. After 72 hours of incubation with 1000µg/ml LDH activity significantly rose above 200%. At concentrations up to 100µg/ml a 150% AP rise could be detected after 24 and 48 hours, which declined to 124% after 72 hours. Within the concentrations of 100 to 1000µg/ml a significant drop in a time-and dose dependent manner was visible with a 37% remaining activity after 72 hours. All displayed effects were reversible, however MTT and AP activity was down to 85% at the highest antibiotic concentrations. For Clindamycin a significant time-and dose dependent drop of MTT was measured, which was quantified at 3,5% after 72 hours at 500µg/ml. For LDH activity no change was noticed up to 100µg/ml. After 48 and 72 hours at 500µg/ml a significant increase above 190% was measured. AP activity was significantly increased after 48 hours at 50µg/ml and then showed a decline after 72 hours at 50 and 100µg/ml and at all times at 500µg/ml. Similar to the AP increase both antibiotics showed highest extracellular matrix calcification at lower antibiotic concentrations with a graded decline at rising concentrations. No calcification could be detected at highest concentrations for both antibiotics.

Discussion:At low antibiotic concentrations, that can be achieved via systemical usage, Cefuroxime and Clindamycin generate a significant increase in cell metabolism as well as result in increased extracellular matrix calcification. No toxic or proliferative effects could be detected at systemically achievable concentrations. At higher, locally achievable concentrations, both antibiotics cause severe toxic and and antimetabolic effects, while the effect of Clindamycin as well was antiproliferative with Cefuroxime causing a proliferative reaction.