Gentamicin May Have an Adverse Effect on Osteogenesis

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Abstract
To investigate the toxic effect of gentamicin at the high concentrations that can be achieved by local administration in the management of bone infection. Randomized, prospective study in cultured cells, with drug exposure duration of 4 days. Cell culture in Dulbecco's modification of Eagle's minimal essential medium with supplements at 37°C in air:CO2 (v:v, 95:5). 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. The cultured cells were exposed to media containing various concentrations of gentamicin (0–1000 μg/mL) for 4 days. Alkaline phosphatase activity, total DNA, and 3H-thymidine incorporation. Alkaline phosphatase activity was significantly decreased (p < 0.05) in all of the cultures at gentamicin concentrations of 100 μg/mL and above. 3H-thymidine incorporation was also decreased (p < 0.05) in three out of four cultures at 100 μg/mL and above. Total DNA was significantly decreased (p < 0.05) at 700 μg/mL and above. 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.