Effectiveness of Chitosan Films Impregnated With Ciprofloxacin for the Prophylaxis of Osteomyelitis in Open Fractures: An Experimental Study in Rats

Costa, Luciane Rezende; Teixeira, Luiz Eduardo Moreira; Lima, Gustavo Silame Maranhão; Ferreira, Marcelo Mendes; Andrade, Mateus Antunes de; Vidigal, Paula Vieira Teixeira; Faraco, André Augusto Gomes; Temponi, Eduardo Frois; Araújo, Ivana Duval

doi:10.5812/atr.36952

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…These findings corroborate the study by Greenberg et al that described rates of 60% of remaining infection after ciprofloxacin systemic treatment for Staphylococcus aureus osteomyelitis. Similar findings were also encountered in animal models studies by Paiva Costa et al 26 , and Penn-Barwell et al 27 that encountered no infection control after systemic ciprofloxacin as an isolated treatment for osseous Staphylococcus aureus infection in rats.…”

Section: ■ Discussionsupporting

confidence: 78%

“…The scintigraphy study demonstrated that treatment using 25% and 50% of ciprofloxacin incorporated in the fracture fixation device was effective in preventing bone infection compared to the control group (p<0.05). However, the use of 10% ciprofloxacin was not effective in preventing bone infection, according to the previous study 26 .…”

Section: ■ Discussionmentioning

confidence: 91%

“…Traditional tecnecium-99 scintigraphy offers high sensibility and low specificity in the detection of acute osseous infections. However, use of ceftizoxime labeled with metastable isomer of technetium-99 ( 99m Tc-ceftizoxime) improved specificity by comparing aseptic osseous inflammation with septic osseous inflammation in previous studies 4,25 .…”

Section: ■ Discussionmentioning

confidence: 99%

“…Lesion analysis was performed in 5 adjacent high power field (HPF) areas for each animal sample. Histological parameters were standardized as intraosseous acute inﬂammation (inflammatory cells infiltration), intraosseous chronic inﬂammation (angiogenesis), periosteal inﬂammation (matrix formation) and bone necrosis 23 - 25 . Therefore, each parameter was graded, classified and divided into two groups: mild or intense.…”

Section: Methodsmentioning

confidence: 99%

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Prevention of bone infection after open fracture using a chitosan with ciprofloxacin implant in animal model

et al. 2020

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To evaluate different concentrations of ciprofloxacin to prevent infection after open fracture contaminated with S. aureus in rats using absorbable local delivery system. Methods: Fifty-two Wistar rats were assigned to six groups. After 4 weeks, all animals underwent 99mTc-ceftizoxima scintigraphy evaluation, callus formation measurement and histological analysis. ANOVA, t-Student and Kruskal Wallis were used for quantitative variables statistical analysis, whereas qui square and exact Fisher were used for qualitative variables. Results: Treatment using 25% and 50% of ciprofloxacin incorporated at the fracture fixation device were effective in preventing bone infection compared to control group (p<0.05). Chitosan were not effective in preventing bone infection when used alone compared to control group (p>0.05). Histological findings demonstrated bone-healing delay with 50% of ciprofloxacin. No difference in callus formation were observed (p>0.05). Conclusion: Local delivery treatment for contaminated open fracture using chitosan with ciprofloxacin is effective above 25%.

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Section: ■ Discussionsupporting

confidence: 78%

Section: ■ Discussionmentioning

confidence: 91%

Section: ■ Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Prevention of bone infection after open fracture using a chitosan with ciprofloxacin implant in animal model

et al. 2020

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“…In recent studies, antibiotics, phages, and lysostaphin released from films/coatings made of phosphatidylcholine, 137,138 hydroxypropylmethlycellulose (HPMC), 35 poly(D,L-lactide) (PDLLA), 139 and a hyaluronic acid/poly-lactic acid hydrogel (DAC) 111 have been explored, among others. 97,[140][141][142][143][144][145][146] Interestingly, silver as a coating material may be used as both an antimicrobial and a delivery vehicle, or combined with other materials such as zeolites (made of aluminum and silicon), which are beneficial in this pairing because of their crystal-like porous structure. 97 In one study, zeolite alone decreased bacterial counts by approximately 3000 units.…”

Section: Coatings/filmsmentioning

confidence: 99%

Therapeutics and delivery vehicles for local treatment of osteomyelitis

Cobb

McCabe

Priddy

2020

Journal Orthopaedic Research

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Osteomyelitis, or the infection of the bone, presents a major complication in orthopedics and may lead to prolonged hospital visits, implant failure, and in more extreme cases, amputation of affected limbs. Typical treatment for this disease involves surgical debridement followed by long‐term, systemic antibiotic administration, which contributes to the development of antibiotic‐resistant bacteria and has limited ability to eradicate challenging biofilm‐forming pathogens including Staphylococcus aureus—the most common cause of osteomyelitis. Local delivery of high doses of antibiotics via traditional bone cement can reduce systemic side effects of an antibiotic. Nonetheless, growing concerns over burst release (then subtherapeutic dose) of antibiotics, along with microbial colonization of the nondegradable cement biomaterial, further exacerbate antibiotic resistance and highlight the need to engineer alternative antimicrobial therapeutics and local delivery vehicles with increased efficacy against, in particular, biofilm‐forming, antibiotic‐resistant bacteria. Furthermore, limited guidance exists regarding both standardized formulation protocols and validated assays to predict efficacy of a therapeutic against multiple strains of bacteria. Ideally, antimicrobial strategies would be highly specific while exhibiting a broad spectrum of bactericidal activity. With a focus on S. aureus infection, this review addresses the efficacy of novel therapeutics and local delivery vehicles, as alternatives to the traditional antibiotic regimens. The aim of this review is to discuss these components with regards to long bone osteomyelitis and to encourage positive directions for future research efforts.

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