Local Antibiotic Delivery Using Tailorable Chitosan Sponges: The Future of Infection Control?

Stinner, Daniel J.; Noel, Scott P.; Haggard, Warren O.; Watson, Jennifer; Wenke, Joseph C.

doi:10.1097/bot.0b013e3181ed296c

Cited by 53 publications

(55 citation statements)

References 18 publications

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“…15,16 These biocompatible sponges can be loaded at the point of care with physician selected antibiotics and then release a high local dose of antibiotic to reduce bacterial levels. 15,16 However, one problem is that these sponges do not degrade quickly and can persist in the wound, after the sponges have delivered the antibiotic. This delayed degradation is a problem because remaining chitosan may act as a nidus for secondary infection.…”

Section: Introductionmentioning

confidence: 99%

Effects of sodium acetate buffer on chitosan sponge properties andin vivodegradation in a rat intramuscular model

et al. 2014

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Chitosan sponges were developed for adjunctive local antibiotic delivery to reduce bacteria in wounds. There is a need to increase sponge degradation for rapid clearance from the wound site during initial wound care. This work examined the effect of using 0.25 M sodium acetate buffers, at pH 4.6 or 5.6, to fabricate sponges with an amorphous chitosan polymer structure. Sponges were evaluated for their crystallinity, thermal, spectroscopic, and morphological properties, in addition to in vitro degradation, and cytocompatibility analysis using normal human dermal fibroblasts. In vivo degradation and biocompatibility were also examined after 4 and 10 days in rat intramuscular tissues. Both buffered chitosan sponge variations exhibited decreases in crystallinity and thermal decomposition temperatures, and increases in surface roughness, which resulted in over 40% increases in degradation over 10 days in vitro compared to the neutral sponges. There were no significant differences between sponges during in vivo degradation over 10 days with respect to histomorphometric analysis of the recovered sponges. These results demonstrated that the acetate buffer did change characteristic chitosan sponge material properties, and increasing the in vivo sponge degradation rate will require balancing material characteristics and processing.

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Section: Introductionmentioning

confidence: 99%

Effects of sodium acetate buffer on chitosan sponge properties andin vivodegradation in a rat intramuscular model

et al. 2014

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Jennings

Courtney

Haggard

2012

Clinical Orthopaedics &Amp; Related Research

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Background Cis-2 decenoic acid (C2DA) disperses biofilm in many strains of microorganisms. However, whether C2DA inhibits bacterial growth or has potential to boost the actions of antibiotics is unknown. Questions/purposes We asked whether (1) C2DA inhibited MRSA growth and biofilm, (2) antibiotics increased inhibitory effects, (3) inhibitory concentrations of C2DA were cytotoxic to human cells, and (4) effective concentrations could be delivered from a chitosan sponge drug delivery device. Methods Broth containing seven concentrations of C2DA and six concentrations of either daptomycin, vancomycin, or linezolid was inoculated with a clinical isolate of MRSA and added to a total of 504 coated microtiter plate wells in triplicate (n = 3) for turbidity bacterial growth and crystal violet biofilm mass quantification. We used fibroblast cell viability assays of six C2DA concentrations (n = 4) to evaluate preliminary biocompatibility. We measured the elution of C2DA from a chitosan sponge drug delivery device with two representative loading concentrations (n = 3).

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“…Unlike PMMA, which requires secondary removal through surgical procedures, phosphatidylcholine coatings are degradable and materials have been used in orthopaedic applications [26]. Through application to the surface directly, more coverage of the potentially contaminated implant site is provided compared with antibiotic-loaded beads or sponges [34,67,70,76]. Interestingly, we observed some inhibitory effect of unloaded phosphatidylcholine on biofilm formation in vitro, which may be a result of the hydrophobic nature of the coating [21].…”

Section: Discussionmentioning

confidence: 64%

Novel Antibiotic-loaded Point-of-care Implant Coating Inhibits Biofilm

Jennings

Carpenter

Troxel

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Orthopaedic biomaterials are susceptible to biofilm formation. A novel lipid-based material has been developed that may be loaded with antibiotics and applied as an implant coating at point of care. However, this material has not been evaluated for antibiotic elution, biofilm inhibition, or in vivo efficacy.Questions/purposes (1) Do antibiotic-loaded coatings inhibit biofilm formation? (2) Is the coating effective in preventing biofilm in vivo? Methods Purified phosphatidylcholine was mixed with 25% amikacin or vancomycin or a combination of 12.5% of both. A 7-day elution study for coated titanium and stainless steel coupons was followed by turbidity and zone of inhibition assays against Staphylococcus aureus and Pseudomonas aeruginosa. Coupons were inoculated with bacteria and incubated 24 hours (N = 4 for each test group). Microscopic images of biofilm were obtained. After washing and vortexing, attached bacteria were counted. A mouse biofilm model was modified to include coated and uncoated stainless steel wires inserted into the lumens of catheters inoculated with a mixture of S aureus or P aeruginosa. Colony-forming unit counts (N = 10) and scanning electron microscopy imaging of implants were used to determine antimicrobial activity. Results Active antibiotics with colony inhibition effects were eluted for up to 6 days. Antibiotic-loaded coatings inhibited biofilm formation on in vitro coupons (log-fold reductions of 4.3 ± 0.4 in S aureus and 3.1 ± 0 for P aeruginosa in phosphatidylcholine-only coatings, 5.6 ± 0 for S aureus and 3.1 ± 0 for P aeruginosa for combinationloaded coatings, 5.5 ± 0.3 for S aureus in vancomycinloaded coatings, and 3.1 ± 0 for P aeruginosa for amikacinloaded coatings (p \ 0.001 for all comparisons of antibiotic-loaded coatings against uncoated controls for both bacterial strains, p \ 0.001 for comparison of antibioticloaded coatings against phosphatidylcholine only for S aureus, p = 0.54 for comparison of vancomycin versus combination coating in S aureus, P = 0.99 for comparison of antibiotic-and unloaded phosphatidylcholine coatings in P aeruginosa). Similarly, antibiotic-loaded coatings reduced attachment of bacteria to wires in vivo (log-fold

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Local Antibiotic Delivery Using Tailorable Chitosan Sponges: The Future of Infection Control?

Abstract: The chitosan sponges are effective delivering the antibiotic and reducing the bacteria within the wounds.

Cited by 53 publications

References 18 publications

Effects of sodium acetate buffer on chitosan sponge properties andin vivodegradation in a rat intramuscular model

Effects of sodium acetate buffer on chitosan sponge properties andin vivodegradation in a rat intramuscular model

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

Novel Antibiotic-loaded Point-of-care Implant Coating Inhibits Biofilm

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