Antibiotic-loaded biomaterials and the risks for the spread of antibiotic resistance following their prophylactic and therapeutic clinical use

Campoccia, Davide; Montanaro, Lucio; Speziale, Pietro; Arciola, Carla Renata

doi:10.1016/j.biomaterials.2010.05.005

Cited by 345 publications

(255 citation statements)

References 182 publications

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“…Therefore, topical Vancomycin is an optimal option whenever possible. It is, inter alia, an epidemiologically safer alternative to the systemic Vancomycin that poses the risk of inducing resistance because of low, subinhibitory concentrations that may occur in some areas of the body, especially during long-term treatment (4).…”

Section: Discussionmentioning

confidence: 99%

The effect of Vancomycin degradation products in the topical treatment of osteomyelitis

Melicherčík¹,

Klapková²,

Landor³

et al. 2014

BLL

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Abstract:Background: The topical application of Vancomycin is increasingly being used in orthopedics because of the development of methicillin resistant bacteria. Consequently, resistance to Vancomycin has recently been on the rise. One possible explanation for this phenomenon could be the thermal degradation of Vancomycin to antibacterially inactive crystalline degradation products (CDP-1s). The aim of our in vitro experiment was to compare the creation and elution characteristics of CDP-1s and the active form of Vancomycin (factor B) released from bone grafts. Methods: CDP-1s and the factor B released from bone grafts into the buffer solution were measured using the high-performance liquid chromatography method at progressive intervals. Results: The factor B was released from bone grafts at the highest levels, typically on the fi rst day (618.8 mg/L). CDP-1 levels kept increasing until the end of measurement on day 15, when the concentration of CDP-1s (1280.7 mg/L) was much higher compared to that of factor B (217.5 mg/L). Conclusions:We confi rmed the tendency of Vancomycin to convert to antimicrobially ineffective CDP-1s. Although Vancomycin is decomposed into crystalline degradation products, its active forms are released from bone grafts in suffi cient concentration for more than two keks (Tab. 3, Fig. 1, Ref. 15). Text in PDF www.elis.sk.

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Section: Discussionmentioning

confidence: 99%

The effect of Vancomycin degradation products in the topical treatment of osteomyelitis

Melicherčík¹,

Klapková²,

Landor³

et al. 2014

BLL

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“…Image taken using a light microscope (originally, 5x magnificiation) of the centre of the defect containing polymer in a control scaffold sheep sacrificed at 2 weeks (Group 3). Biodegradable antibiotic-impregnated scaffold minimum of 7 days for effective prevention of infection (Campoccia et al, 2010). No zones of inhibition were seen after Day 21.…”

Section: Discussionmentioning

confidence: 99%

A biodegradable antibiotic-impregnated scaffold to prevent osteomyelitis in a contaminated in vivo bone defect model

McLaren

White²,

Cox³

et al. 2014

eCM

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Open fractures are at risk of serious infection and, if infected, require several surgical interventions and courses of systemic antibiotics. We investigated a new injectable formulation that simultaneously hardens in vivo to form a porous scaffold for bone repair and delivers antibiotics at high concentrations to the local site of infection. Duration of antimicrobial activity against Staphylococcus aureus was determined using the serial plate transfer test. Ultimate compressive strength and porosity of the material was measured with and without antibiotics. The material was evaluated in vivo in an ovine medial femoral condyle defect model contaminated with S. aureus. Sheep were sacrificed at either 2 or 13 weeks and the defect and surrounding bone assessed using micro-computed tomography and histology. Antimicrobial activity in vitro persisted for 19-21 days. Sheep with antibiotic-free material and bacteria became infected, while those with antibiotic-containing material and bacteria did not. Similarly, new bone growth was seen in uninoculated animals with plain polymer, and in those with antibiotic polymer with bacteria, but not in sheep with plain polymer and bacteria. The antibiotic-impregnated scaffolds were effective in preventing S. aureus infections whilst supporting bone growth and repair. If translated into clinical practice, this approach might reduce the need for systemic antibiotics.

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“…Currently used antibiotic-loaded cement, beads, and spacers or powder do not confer tunable release of multiple antibiotics (18)(19)(20). This may compromise the treatment efficiency and it increases the likelihood of the development of antibiotic resistance while patients are on therapy (21,22), which has been seen in as high as 50% of patients with PJI treated with gentamicin or tobramycin spacers (43). A recently approved dual antibiotic release mesh envelope impregnated with minocycline and rifampin has proven effective in preventing CIED infection in patients (44,45).…”

Section: Discussionmentioning

confidence: 99%

“…However, most of these approaches are only designed for single antibiotic release, which increases the likelihood of the development of antibiotic resistance while patients are on therapy (21,22). Therefore, we developed a conformal implant coating capable of local delivery of combinatorial antibiotics with tailored release profiles for each drug to effectively prevent biofilm formation and ensuing infectious complications.…”

mentioning

confidence: 99%

Polymeric nanofiber coating with tunable combinatorial antibiotic delivery prevents biofilm-associated infection in vivo

Ashbaugh

Jiang

Zheng

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Bacterial biofilm formation is a major complication of implantable medical devices that results in therapeutically challenging chronic infections, especially in cases involving antibiotic-resistant bacteria.As an approach to prevent these infections, an electrospun composite coating comprised of poly(lactic-coglycolic acid) (PLGA) nanofibers embedded in a poly(e-caprolactone) (PCL) film was developed to locally codeliver combinatorial antibiotics from the implant surface. The release of each antibiotic could be adjusted by loading each drug into the different polymers or by varying PLGA:PCL polymer ratios. In a mouse model of biofilm-associated orthopedic-implant infection, three different combinations of antibiotic-loaded coatings were highly effective in preventing infection of the bone/joint tissue and implant biofilm formation and were biocompatible with enhanced osseointegration. This nanofiber composite-coating technology could be used to tailor the delivery of combinatorial antimicrobial agents from various metallic implantable devices or prostheses to effectively decrease biofilm-associated infections in patients.nanofiber | biofilm | infection | antibiotic | delivery

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Antibiotic-loaded biomaterials and the risks for the spread of antibiotic resistance following their prophylactic and therapeutic clinical use

Cited by 345 publications

References 182 publications

The effect of Vancomycin degradation products in the topical treatment of osteomyelitis

The effect of Vancomycin degradation products in the topical treatment of osteomyelitis

A biodegradable antibiotic-impregnated scaffold to prevent osteomyelitis in a contaminated in vivo bone defect model

Polymeric nanofiber coating with tunable combinatorial antibiotic delivery prevents biofilm-associated infection in vivo

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