Vancomycin-Modified Implant Surface Inhibits Biofilm Formation and Supports Bone-Healing in an Infected Osteotomy Model in Sheep

Abstract

Background: Implant-associated infections contribute to patient morbidity and health care costs. We hypothesized that

A fully functional drug-eluting joint implant

“…This is in agreement with previous reports on vancomycin grafting on titanium preventing biofilm formation on its surface [52]. Reduction of bacterial adherence was shown to reduce the infection rate [53]. Surface-bound vancomycin has been shown to eradicate bacteria by making the peptidoglycan layer essential to biofilm formation less rigid and more permeable.…”

CORR Insights™: High Infection Rate Outcomes in Long-bone Tumor Surgery with Endoprosthetic Reconstruction in Adults: A Systematic Review

“…Other issues such as how large prosthetic surfaces and modular components with fretting at taper junctions affect the rates of deep infection warrant basic research effort. Translational work to develop infection-resistant prostheses such as silver- [3] or iodine-coated [8] prostheses, or targeted application of antibiotics on the implants [7] are exciting new strategies. Creative solutions such as these deserve prioritization by specialty groups and funding agencies.…”

Biodegradable drug-eluting nanofiber-enveloped implants for sustained release of high bactericidal concentrations of vancomycin and ceftazidime: in vitro and in vivo studies

“…Stewart et al reported the development of titanium plates bonded with vancomycin to effectively inhibit biofilm formation and support bone healing in an infected osteotomy animal model. 6 To the best of our knowledge, the development of drug-eluting nanofiber-enveloped plates has not been previously reported.…”

“…[6][7][8] PLGA is a promising biodegradable material that has been used for implantable and injectable controlled-release drug-delivery systems. 9,10 The copolymer has also been approved for clinical applications because it is nontoxic, instigates a minimal inflammatory response, and is biodegradable through the hydrolysis of its ester linkage to transform biocompatible lactic and glycolic acids.…”

“…Stewart et al reported that vancomycin-derived plate surfaces inhibited implant colonization by S. aureus. 6 Even though these plates showed promising inhibition of biofilm formation, bactericidal antibiotic concentration in the surrounding tissue was not demonstrated. In the study reported here, we developed biodegradable PLGA/antibiotic nanofibrous membrane-enveloped plates to provide sustained delivery of vancomycin and ceftazidime for infection treatment.…”