ArticleInternational orthopaedics2026
Pre-sterilization of vancomycin-loaded cement spacers: impact on antibacterial efficacy against Staphylococcus aureus.
Article in International orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Local antibiotic treatment for periprosthetic joint infection: current approaches and the emerging role of continuous local antibiotic perfusion.International orthopaedics · 2026Review
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibiotic-loaded polymethylmethacrylate (PMMA) cement spacers are widely used in periprosthetic joint infection and chronic osteomyelitis. Manual prefabrication and sterilisation of non-commercial antibiotic-loaded cement may reduce operative time and cost; however, the effects of sterilisation and storage on antimicrobial efficacy remain unclear.
methodsManually prefabricated PMMA cement containing vancomycin (2 g or 4 g) underwent formaldehyde gas sterilisation (FO) and storage for one, four or seven days. Antibiotic elution was evaluated over 28 days. Antimicrobial activity against Staphylococcus aureus ATCC 25923 was assessed using minimum inhibitory dilution (MID) testing at predefined time points. Given the small number of specimens per subgroup, all comparisons should be interpreted as preliminary and hypothesis-generating.
resultsFO sterilisation significantly reduced antimicrobial activity during the early elution phase. In the 4-g vancomycin group, Day 1 MID values were significantly higher in one day storage sterilised specimens than in specimens stored for four or seven days (1024 µg/mL vs. 213 µg/mL and 213 µg/mL, respectively; P < 0.001). Differences persisted at early time points but were no longer significant during the sustained elution phase (Days 14-28; P > 0.05). Overall, sterilised cement containing 4 g of vancomycin demonstrated higher MID values than 2 g cement during the early and mid-elution phases (Days 1-14; P < 0.01). MID values in all sterilised specimens remained several-fold above inhibitory thresholds for S. aureus throughout the 28-day period.
conclusionsFO sterilisation transiently reduces vancomycin antimicrobial activity during the early elution phase (Days 1-7) but does not affect sustained antimicrobial efficacy compared with non-sterilised cement. Based on these findings, vancomycin-loaded PMMA cement containing 4 g of antibiotic may be sterilised and stored for up to seven days while maintaining MIC values several-fold above inhibitory thresholds for Staphylococcus aureus throughout the 28-day elution period.
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