Formulation and Quality – Chemical
2019 PharmSci 360
By 2030, Total Joint Replacement (TJR) is predicted to become the number one elective surgery in the USA, with over 5 million procedures each year. Up-to 25% of revision surgeries are due to infection, many caused by Staphylococcus aureus biofilm. Due to the complex nature of TJR and local long bone environment, these infections are difficult to treat. The presence of biofilm on the prostheses may necessitate replacement of the implant in multi-stage surgery. Bone cement for local antibiotic delivery is considered standard treatment which works against planktonic bacteria but not against biofilm. Rifampicin is a good antibiofilm antibiotic, but not compatible with bone cement. Rifampicin is advised to be used with another antibiotic. A locally implantable antibiotic-releasing Bone Void Filler (ABVF) putty which releases rifampicin and vancomycin, biodegradable and promotes bone healing can effectively treat bacterial biofilm infections and will lead to reduced number of surgeries and antibacterial resistance.