Journal of Bone and Joint Infection · Published 2026-05-08 · DOI 10.5194/jbji-11-257-2026
<p><strong>Introduction</strong>: Achieving sustained local antibiotic concentrations is critical for managing orthopedic infections. This proof-of-concept study evaluated release kinetics, local/systemic concentrations, and histological responses to CarboCell G/C, an injectable gentamicin- and clindamycin-eluting depot in a porcine bone void model. <strong>Methods</strong>: CarboCell G/C containing 111 mg g<span class="inline-formula"><sup>−1</sup></span> gentamicin-docusate and 70 mg g<span class="inline-formula"><sup>−1</sup></span> clindamycin was injected into and around a tibial bone void in 11 pigs. Antibiotic concentrations in target tissues and systemic spillover were measured at 1–12 h by microdialysis and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) and in tissue homogenates at 1, 3, and 7 d. Release was quantified by high-performance liquid chromatography (HPLC), and tolerability was assessed histologically. <strong>Results</strong>: Microdialysis showed high stable antibiotic tissue levels during the first 12 h with minimal systemic spillover. Peak gentamicin and clindamycin concentrations in bone were 730 <span class="inline-formula">±</span> 170 and 3700 <span class="inline-formula">±</span> 700 <span class="inline-formula">µg</span> g<span class="inline-formula"><sup>−1</sup></span> and 42 <span class="inline-formula">±</span> 15 and 360 <span class="inline-formula">±</span> 120 <span class="inline-formula">µg</span> g<span class="inline-formula"><sup>−1</sup></span> in soft tissue, respectively. Tissue half-lives ranged from 43–62 h for clindamycin and 40–46 h for gentamicin. Recovered depots had released <span class="inline-formula">∼</span> 30 %–50 % of their antibiotic content at day 1 and <span class="inline-formula">∼</span> 60 %–80 % by day 7. Depots elicited a mild–moderate local inflammatory response. <strong>Conclusion</strong>: CarboCell G/C provides sustained high local antibiotics for at least 7 d with minimal systemic spillover, supporting further evaluation in orthopedic infection management.</p>
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