Antibiotic Loaded Nano Rod Bone Cement for the Treatment of Osteomyelitis

Abstract

Background: Polymethyl methacrylate (PMMA) bone cement is the clinical gold standard biomaterial for local antibiotic therapy in osteomyelitis. However, it releases 50% of the antibiotic within first three days. It generates excessive heat during polymerization and is non-biodegradable. It must be removed by another operation. The best-known alternative for PMMA is hydroxyapatite. Objective: The present work is focused to synthesize the biodegradable hydroxyapatite in nano form for slow and sustained release of antibiotics and to study the release kinetics of antibiotics. Method: Nano-hydroxyapatite was synthesized by co-precipitation method and characterized by particle size analyser, transmission emission microscopy, fourier transform infrared spectroscopy and energy dispersive X-Ray analysis. Antibiotic loaded nano-hydroxyapatite was prepared as 7 mm beads. The efficiency of drug loaded nano- hydroxyapatite beads against osteomyelitic isolates were evaluated by well diffusion assay. Zero order, first order, second order, Higuchi model Korsmeyer-Peppas and Gompertz model were fit into the release kinetics of antibiotics from hydroxyapatite. Results: Average size of nano-hydroxyapatite was 5 nm. The bactericidal activity exhibited by antibiotic loaded micro sized hydroxyapatite was therapeutic until 10 days only whereas antibiotic loaded nano-hydroxyapatite was therapeutic until 8 weeks. This confirms the burst release of antibiotics from micro sized hydroxyapatite beads. In contrast, the release was slow and sustained upto 8 weeks from nano-hydroxyapatite. Koresmeyer-Peppas model fits into the release kinetics of antibiotics from nano-hydroxyapatite. Conclusion: Nano-hydroxyapatite with Ca/P ratio of 1.78 is suitable for the slow and sustained delivery of antibiotics for 8 weeks.

Evaluating the efficacy of combined flap coverage, antibiotic‐loaded bone cement and negative pressure irrigation in traumatic osteomyelitis management

“…Second, the antibiotic bone cement acts as a barrier between the bone tissue and external environment. This not only minimises the risk of infection but also accelerates recovery by maintaining a closed antibacterial environment 35 . The reduced hospital stays and fewer dressing changes in the observation group, as highlighted in our study, signify a quicker recovery and lower resource expenditure.…”

In-vitro model for bacterial growth inhibition of compartmentalized infection treated by an ultra-high concentration of antibiotics

“…Most literature published to date deals with prevention [ 25 , 26 ]. Some studies published recently describe local antibiotic administration in treating established infections [ 27 , 28 ]. In the early in-vivo experimental report of the clinical implementation of the CITA treatment method for localized infection of CIEDs, the antibiotics were provided at the infection site, proved effective, with a CIED salvage rate of over 80% [ 14 ].…”

Nano-Hydroxyapatite Composite Scaffolds Loaded with Bioactive Factors and Drugs for Bone Tissue Engineering

“…The n-HAp composite scaffold has favorable biological activity and biocompatibility, can completely and effectively release the loaded antibiotics and provides a proper environment for new bone formation. Therefore, n-HAp is considered as one of the most promising biomaterials in drug delivery system for treating osteomyelitis [ 140 , 141 ]. Some recent studies on n-HAp composite scaffolds loaded with antibiotics are presented below.…”