Chitosan Sponges to Locally Deliver Amikacin and Vancomycin: A Pilot In Vitro Evaluation

Abstract

Background Open orthopaedic wounds are ideal sites for infection. Preventing infection in these wounds is critical for reducing patient morbidity and mortality, controlling antimicrobial resistance and lowering the cost of treatment. Localized drug delivery has the potential to overcome the challenges associated with traditional systemic dosing. A degradable, biocompatible polymer sponge (chitosan) that can be loaded with clinician-selected antibiotics at the point of care would provide the patient and clinician with a desirable, adjunctive preventive modality. Questions/purposes We asked (1) if an adaptable, porous chitosan matrix could absorb and elute antibiotics for 72 hours for potential use as an adjunctive therapy to débri-dement and lavage; and (2) if the sponges could elute levels of antibiotic that would inhibit growth of Staphylococcus aureus and Pseudomonas aeruginosa? Methods We fabricated a degradable chitosan sponge that can be loaded with antibiotics during a 60-second hydration in drug-containing solution. In vitro evaluation determined amikacin and vancomycin release from chitosan sponges at six time points. Activity tests were used to assess the release of inhibitory levels of amikacin and vancomycin. Results Amikacin concentration was 881.5 lg/mL after 1 hour with a gradual decline to 13.9 lg/mL after 72 hours. Vancomycin concentration was 1007.4 lg/mL after 1 hour with a decrease to 48.1 lg/mL after 72 hours. Zone of inhibition tests were used to verify inhibitory levels of drug release from chitosan sponges. A turbidity assay testing activity of released amikacin and vancomycin indicated inhibitory levels of elution from the chitosan sponge. Clinical Relevance Chitosan sponges may provide a potential local drug delivery device for preventing musculoskeletal infections.

Chitosan as a starting material for wound healing applications

“…Another study used a porous chitosan sponge for absorption of amikacin and vancomycin antibiotics in solution over 72h. The in vitro elution results showed that chitosan sponge loaded with an antibiotic can be used as drug carrier for treating and protecting wounds against infections (Noel et al, 2010).…”

Chitosan–tripolyphosphate nanoparticles as Arrabidaea chica standardized extract carrier: synthesis, characterization, biocompatibility, and antiulcerogenic activity

“…43 Noel et al 44 and Smith et al 45 suggested the possibility of using a CS sponge device as an alternative to deliver antibiotics locally as an adjunctive therapy for the treatment and prevention of infections, from open traumatic wounds to prophylactic use in surgical sites. Furthermore, a CS sponge can be used as a drug reservoir 43 or a storage form for CS systems.…”

Cis-2-decenoic Acid Inhibits S. aureus Growth and Biofilm In Vitro: A Pilot Study

“…Local drug delivery carriers, such as calcium sulfate, collagen, or chitosan, have been effective in targeted, local delivery of C2DA [22,26,41]. For these initial pilot studies, the chitosan sponge was chosen for evaluation because it was a biocompatible delivery device that released antimicrobial compounds at therapeutic levels [36,41]. To establish the preliminary feasibility of local delivery of C2DA, the effects of inhibitory concentrations of C2DA on cell survival and proliferation should be evaluated to determine potential cytotoxic effects and to optimize dosing strategies.…”