Bacterial adhesion on antibiotic-loaded polymethylmethacrylate bone cement

Polymethylmethacrylate (PMMA) bone cement, commonlyused for the fixation of joint prostheses and also for orthopaedicdevices, may be colonised by Gram positive cocci. The use of antibioticloadedPMMA should prevent bacterial colonisation of cement surfaces.Biofilm formation on bone cement could be more effectively reduced by incorporation of a second antibiotic The aim of our study was to evaluate the in vitro effects of gentamicin (G)- and vancomycin (V)-loaded PMMA cement specimens on the bacterial adhesion of multiresistant clinical isolates staphylococci.The presence of G in PMMA specimens reduces thebacterial adhesion in susceptible and intermediate-resistant Staphylococci. The combination G-V exhibits synergistic activity against all strains; moreover, inhibits the growth and adhesion of V-resistant strains. The anti-adhesive effect of the antibiotic-loaded cement depends on the characteristics of the microorganism and its capacity of adhering to antibiotic-loaded surfaces. (iv) Bacterial adhesion is reduced in specimens presenting a higher capacity of antibiotic elution.