{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:12:13Z","timestamp":1784121133482,"version":"3.55.0"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: The use of antibiotic-loaded bone cements (ALBCs) in arthroplasty has been well established for the prevention and treatment of infections. Tigecycline (Tig), a broad-spectrum antibiotic, has shown efficacy against various pathogens, including vancomycin-resistant strains. Method: ISO and DIN mechanical and microbiological inhibition zone tests were performed on PMMA cement with manually added Tigecycline. Results: Manually adding 0.5 and 1.0 g Tigecycline to PMMA always meets the mechanical requirements of ISO and DIN standards. Mixtures containing 0.5 g were microbiologically effective for up to 7 days and those containing 1.0 g were effective for 28\u201342 days. Conclusion: In revision surgery, manually adding Tigecycline in doses of 0.5\u20131 g to 40 g of PMMA is effective against MRSA, VRE, and ESBL without negatively affecting the cement\u2019s properties.<\/jats:p>","DOI":"10.3390\/antibiotics13111102","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T11:58:07Z","timestamp":1732017487000},"page":"1102","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tigecycline Containing Polymethylmethacrylate Cement Against MRSA, VRE, and ESBL\u2014In Vitro Mechanical and Microbiological Investigations"],"prefix":"10.3390","volume":"13","author":[{"given":"Michael","family":"Abramowicz","sequence":"first","affiliation":[{"name":"KABEG, LKH Villach, 9500 Villach, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrej","family":"Trampuz","sequence":"additional","affiliation":[{"name":"Faculty of Health, School of Clinical Medicine, Queensland University of Technology (QUT), Brisbane 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus-Dieter","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Medical University Graz, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jot.2020.04.005","article-title":"Antibiotic containing bone cement in prevention of hip and knee prosthetic joint infections: A systematic review and meta-analysis","volume":"23","author":"Sebastian","year":"2020","journal-title":"J. Orthop. Translat."},{"key":"ref_2","unstructured":"Ochsner, P., Borens, O., Bodler, P.-M., Broger, I., Eich, G., Hefti, F., Maurer, T., N\u00f6tzli, H., Seiler, S., and Suva, D. (2014). Infections of the Musculoskeletal System. Basic Principles, Prevention, Diagnosis and Treatment, Swiss Orthopaedics and the Swiss Society for Infectious Diseases Expert Group \u201cInfections of the musculoskeletal system\u201d. [1st ed.]. (In English)."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Blersch, B.P., Sax, F.H., Mederake, M., Benda, S., Schuster, P., and Fink, B. (2024). Effect of Multiantibiotic-Loaded Bone Cement on the Treatment of Periprosthetic Joint Infections of Hip and Knee Arthroplasties\u2014A Single Center Retrospective Study. Antibiotics, 13.","DOI":"10.3390\/antibiotics13060524"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Cara, A., Ballet, M., Hemery, C., Ferry, T., Laurent, F., and Josse, J. (2021). Antibiotics in Bone Cements Used for Prosthesis Fixation: An Efficient Way to Prevent Staphylococcus aureus and Staphylococcus epidermidis Prosthetic Joint Infection. Front. Med., 7.","DOI":"10.3389\/fmed.2020.576231"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hofmann, J., Bewersdorf, T.N., Sommer, U., Lingner, T., Findeisen, S., Schamberger, C., Schmidmaier, G., and Gro\u00dfner, T. (2024). Impact of Antibiotic-Loaded PMMA Spacers on the Osteogenic Potential of hMSCs. Antibiotics, 13.","DOI":"10.3390\/antibiotics13010044"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"441","DOI":"10.2106\/JBJS.N.00023","article-title":"International consensus on periprosthetic joint infection: Let cumulative wisdom be a guide","volume":"96","author":"Parvizi","year":"2014","journal-title":"J. Bone Jt. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kendoff, D., Morgan-Jones, R., and Haddad, F.S. (2016). Local Antibiotic Therapy: Antibiotic-Loaded Cement. Periprosthetic Joint Infections \u201cChanging Paradigms\u201d, Springer International Publishing.","DOI":"10.1007\/978-3-319-30091-7"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1002\/jbm.b.31088","article-title":"Antimicrobial properties and elution kinetics of linezolid-loaded hip spacers in vitro","volume":"87","author":"Anagnostakos","year":"2008","journal-title":"J. Biomed. Mater. Res. Part B Appl. Biomater."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jpra.2017.10.001","article-title":"Treatment of a chronically infected nasal silicone prosthesis with continuous antibiotic irrigation and gentamicin-impregnated polymethylmethacrylate beads","volume":"15","author":"Villanueva","year":"2017","journal-title":"JPRAS Open"},{"key":"ref_10","unstructured":"K\u00fchn, K.D. (2018). Therapy using Antibiotic loaded PMMA. Management of Periprosthetic Joint Infection\u2014A Global Perspective on Diagnosis, Treatment Options, Prevention Strategies and Their Economic Impact, Springer."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Lee, S.H., Tai, C.L., Chen, S.Y., Chang, C.H., Chang, Y.H., and Hsieh, P.H. (2016). Elution and mechanical strength of vancomycin-loaded bone cement: In vitro study of the influence of brand combination. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0166545"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1016\/j.arth.2015.02.040","article-title":"Evaluation of elution and mechanical properties of high-dose antibiotic-loaded bone cement: Comparative \u201cIn Vitro\u201d study of the influence of vancomycin and cefazolin","volume":"30","author":"Paz","year":"2015","journal-title":"J. Arthroplast."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Li, G., Walker, M.J., and De Oliveira, D.M.P. (2023). Vancomycin Resistance in Enterococcus and Staphylococcus aureus. Microorganisms, 11.","DOI":"10.3390\/microorganisms11010024"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Humez, M., Domann, E., Thormann, K.M., F\u00f6lsch, C., Strathausen, R., Vogt, S., Alt, V., and K\u00fchn, K.D. (2023). Daptomycin-Impregnated PMMA Cement against Vancomycin-Resistant Germs: Dosage, Handling, Elution, Mechanical Stability, and Effectiveness. Antibiotics, 12.","DOI":"10.20944\/preprints202310.0589.v1"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Jiang, C., Yang, J., Xiao, G., Xiao, N., Hu, J., Yang, Y., Sun, Z., and Li, Y. (2024). The ISVsa3-ORF2-abh-tet(X4) circular intermediate-mediated transmission of tigecycline resistance in Escherichia coli isolates from duck farms. Front. Cell. Infect. Microbiol., 14.","DOI":"10.3389\/fcimb.2024.1444031"},{"key":"ref_16","first-page":"e65617","article-title":"Tigecycline-Based Regimens for Complicated Urinary Tract Infections Caused by Carbapenem-Resistant gram-Negative Bacteria: Case Series","volume":"16","author":"Niculae","year":"2024","journal-title":"Cureus"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1080\/09546630510011810","article-title":"Tigecycline: A review of a new glycylcycline antibiotic","volume":"16","author":"Scheinfeld","year":"2005","journal-title":"J. Dermatol. Treat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1179\/joc.2008.20.4.411","article-title":"Tigecycline: A critical update","volume":"20","author":"Shakil","year":"2008","journal-title":"J. Chemother."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1093\/jac\/dki248","article-title":"Tigecycline","volume":"56","author":"Pankey","year":"2005","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S303","DOI":"10.1086\/431672","article-title":"Tigecycline: A new glycylcycline for treatment of serious infections","volume":"41","author":"Noskin","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1007\/s10096-010-0886-2","article-title":"In vitro activity of tigecycline against methicillin-resistant Staphylococcus aureus, including livestock-associated strains","volume":"29","author":"Verkade","year":"2010","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1007\/s10096-020-04121-1","article-title":"Tigecycline antibacterial activity, clinical effectiveness, and mechanisms and epidemiology of resistance: Narrative review","volume":"41","author":"Yaghoubi","year":"2022","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1007\/s10096-010-0950-y","article-title":"Antibiotic resistance in orthopaedic surgery: Acute knee prosthetic joint infections due to extended-spectrum \u03b2-lactamase (ESBL)-producing Enterobacteriaceae","volume":"29","author":"Vilchez","year":"2010","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"279","DOI":"10.5194\/jbji-7-279-2022","article-title":"Osteosynthesis-associated infection of the lower limbs by multidrug-resistant and extensively drug-resistant gram-negative bacteria: A multicentre cohort study","volume":"7","author":"Giannitsioti","year":"2022","journal-title":"J. Bone Jt. Infect."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1590\/S1413-86702006000300010","article-title":"Overview of tigecycline and its role in the era of antibiotic resistance","volume":"10","author":"Rossi","year":"2006","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kreis, C.A., Raschke, M.J., Ro\u00dflenbroich, S.B., Tholema-Hans, N., L\u00f6ffler, B., and Fuchs, T. (2013). Therapy of intracellular Staphylococcus aureus by tigecyclin. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-267"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1186\/s13018-023-04055-2","article-title":"Comparison of antibacterial activity and biocompatibility of non-leaching nitrofuran bone cement loaded with vancomycin, gentamicin, and tigecycline","volume":"18","author":"Gao","year":"2023","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1093\/jac\/dkw410","article-title":"Analysis of linezolid and tigecycline as candidates for local prophylaxis via antibiotic-loaded bone cement","volume":"72","author":"Nichol","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"126","DOI":"10.7150\/jbji.34866","article-title":"Clinical Experience with Tigecycline in the Treatment of Prosthetic Joint Infections","volume":"4","author":"Lastinger","year":"2019","journal-title":"J. Bone Jt. Infect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"535","DOI":"10.5152\/j.aott.2020.19086","article-title":"Biomechanical comparison of tigecycline loaded bone cement with vancomycin and daptomycin loaded bone cements","volume":"54","author":"Karatosun","year":"2020","journal-title":"Acta Orthop. Traumatol. Turc."},{"key":"ref_31","unstructured":"(2002). Implants for Surgery\u2014Acrylic Resin Cements (Standard No. ISO 5833)."},{"key":"ref_32","unstructured":"(2018). Testing of Plastics\u2014Bending Test and Impact Test on Dynstat Test Specimens (Standard No. DIN 53435)."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Krampitz, B., Steiner, J., Trampuz, A., and K\u00fchn, K.D. (2023). Voriconazole Admixed with PMMA-Impact on Mechanical Properties and Efficacy. Antibiotics, 12.","DOI":"10.3390\/antibiotics12050848"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijantimicag.2008.11.006","article-title":"Tigecycline in combination with other antimicrobials: A review of in vitro, animal and case report studies","volume":"34","author":"Entenza","year":"2009","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1093\/jac\/dki109","article-title":"Comparative evaluation of tigecycline and vancomycin, with and without rifampicin, in the treatment of methicillin-resistant Staphylococcus aureus experimental osteomyelitis in a rabbit model","volume":"55","author":"Yin","year":"2005","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Elgazzar, D., Aboubakr, M., Bayoumi, H., Ibrahim, A.N., Sorour, S.M., El-Hewaity, M., Elsayed, A.M., Shehata, S.A., Bayoumi, K.A., and Alsieni, M. (2022). Tigecycline and Gentamicin-Combined Treatment Enhances Renal Damage: Oxidative Stress, Inflammatory Reaction, and Apoptosis Interplay. Pharmaceuticals, 15.","DOI":"10.3390\/ph15060736"},{"key":"ref_37","unstructured":"(2024, September 21). Web Palacos\/Palacos R+G HME. Available online: https:\/\/www.heraeus-medical.com\/en-us\/search\/?searchTerm=Instructions+for+user."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/11\/1102\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:35:27Z","timestamp":1760114127000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/11\/1102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,19]]},"references-count":37,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["antibiotics13111102"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics13111102","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,19]]}}}