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A bioresorbable calcium phosphate delivery system with teicoplanin for treating MRSA osteomyelitis
J Lazarettos1, N Efstathopoulos, P J Papagelopoulos
1Second Department of Orthopaedics, University of Athens, Athens, Greece.
Abstract:
To assess the effectiveness of calcium phosphate as a delivery system of teicoplanin, methicillin-resistant Staphylococcus aureus osteomyelitis was induced in 36 rabbits. Osteomyelitis was induced by inoculating 10 cfu of methicillin-resistant Staphylococcus aureus isolate into a 2-mm hole at the upper 1/3 of the femur for 3 weeks, when all animals had reoperations, and calcium phosphate cement with 3% teicoplanin was implanted. Animals were divided into six groups of six animals each, sacrificed at Weeks 1, 2, 3, 4, 5, and 6, respectively, after implantation. One rabbit in each group was used as a control. Substantial clinical improvement of the rabbits was observed after implantation, accompanied with sterile cultures of bone after the second week of treatment. Throughout the same period, 10 to 10 cfu/g of methicillin-resistant Staphylococcus aureus isolate was cultured from the control samples. Bacterial eradication signified a considerable decrease of the total histologic scores of osteomyelitis compared with controls, accompanied with newly growing host bone. The calcium phosphate with teicoplanin delivery system seems promising for treatment of bone infection attributable to methicillin-resistant Staphylococcus aureus. In addition, this mixture allows filling of bone defects by new host bone.
Insights
Calcium phosphate cement effectively delivered teicoplanin to treat methicillin-resistant Staphylococcus aureus osteomyelitis in rabbits, leading to clinical improvement and bone healing. This bone graft material shows promise for treating bone infections.
Area of Science:
- Biomaterials Science
- Infectious Diseases
- Orthopedic Surgery
Background:
- Osteomyelitis, particularly that caused by methicillin-resistant Staphylococcus aureus (MRSA), presents a significant clinical challenge.
- Effective local delivery of antibiotics is crucial for eradicating deep-seated bone infections.
- Calcium phosphate cement is a well-established bone void filler with potential for drug delivery.
Purpose of the Study:
- To evaluate the efficacy of calcium phosphate cement as a delivery system for teicoplanin in treating MRSA osteomyelitis.
- To assess the impact of this combined treatment on bacterial eradication and bone regeneration in a rabbit model.
Main Methods:
- Osteomyelitis was induced in rabbit femurs by inoculation with MRSA.
- Following infection establishment, calcium phosphate cement loaded with 3% teicoplanin was surgically implanted.
- Animals were divided into treatment and control groups, with sacrifice at various time points post-implantation for analysis.
Main Results:
- Significant clinical improvement was observed in rabbits treated with teicoplanin-loaded calcium phosphate cement.
- Bone cultures became sterile by the second week of treatment, contrasting with persistent MRSA in control groups.
- Histological examination revealed decreased osteomyelitis scores and evidence of new host bone formation.
Conclusions:
- Calcium phosphate cement serves as a promising local delivery system for teicoplanin in treating MRSA osteomyelitis.
- The combination of antibiotic delivery and bone defect filling promotes infection resolution and bone regeneration.
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