Abstract
OBJECTIVE
To investigate the toxic effect of gentamicin at the high concentrations that can be achieved by local administration in the management of bone infection.
DESIGN
Randomized, prospective study in cultured cells, with drug exposure duration of 4 days.
SETTING
Cell culture in Dulbecco's modification of Eagle's minimal essential medium with supplements at 37 degrees C in air:CO2 (v:v, 95:5).
MATERIALS
Human osteoblastlike cells derived from cancellous bone collected from four adult patients without systemic disease during total hip replacement were cultured in antibiotic-free medium for 4 weeks.
INTERVENTION
The cultured cells were exposed to media containing various concentrations of gentamicin (0-1000 microg/mL) for 4 days.
MAIN OUTCOME MEASUREMENTS
Alkaline phosphatase activity, total DNA, and 3H-thymidine incorporation.
RESULT
Alkaline phosphatase activity was significantly decreased (p < 0.05) in all of the cultures at gentamicin concentrations of 100 microg/mL and above. 3H-thymidine incorporation was also decreased (p < 0.05) in three out of four cultures at 100 microg/mL and above. Total DNA was significantly decreased (p < 0.05) at 700 microg/mL and above.
CONCLUSION
Gentamicin, at high concentrations, as achieved following topical application, inhibits cell proliferation in vitro and, therefore, may be detrimental to the repair process in vivo.
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