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Published on: March 14, 2019
Microwaves increase the effectiveness of systemic antibiotic treatment in acute bone infection: experimental study in
Xiao-Yang Qi1,2, Xu-Sheng Qiu3,4, Jiang-Yun Jiang1
1Department of Orthopaedics, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, China.
Background:
Osteomyelitis is a challenge for orthopedic surgeons due to its protracted treatment process. Microwaves (MWs) can increase blood perfusion due to their thermal effect. Furthermore, MWs demonstrated significant bactericidal effects in vitro. In the present study, we assumed that the application of a 2450-MHz-frequency MW together with systemic antibiotic treatment would provide synergy for the treatment of acute osteomyelitis.
Methods:
The medullary cavity of the right tibia was inoculated with 107 CFU of methicillin-sensitive Staphylococcus aureus (MSSA-ATCC 29213) in 40 rats, and the rats were randomly divided into four groups according to treatment: group I, saline (control); group II, saline + MW therapy; group III, systemic cefuroxime; and group IV, systemic cefuroxime + MW therapy. MWs were applied for 20 min per day to the infected limbs, and all rats were sacrificed on the 7th day. The severity of tibial osteomyelitis was assessed by quantitative culture analysis.
Results:
Bacterial counts in groups III and IV were significantly reduced compared with those in the control (p = 0.001 and < 0.001, respectively). Furthermore, significant differences were detected between groups III and IV (p = 0.033). However, the difference between groups I and II was nonsignificant (p = 0.287).
Conclusion:
Our experimental model suggests that MW therapy provides a significant synergy for systemic antibiotic treatment. However, further clinical trials are required to safely use this treatment modality in patients.
Insights
Microwave therapy combined with antibiotics significantly enhanced osteomyelitis treatment in rats. This approach shows promise for improving outcomes in challenging bone infection cases.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomedical Engineering
Background:
- Osteomyelitis presents a significant clinical challenge due to its complex and lengthy treatment requirements.
- Microwaves (MWs) possess thermal properties that enhance blood perfusion and exhibit direct bactericidal effects in vitro.
- The potential synergistic effect of MW therapy with antibiotic treatment for acute osteomyelitis warrants investigation.
Purpose of the Study:
- To evaluate the synergistic efficacy of 2450-MHz microwave (MW) therapy combined with systemic antibiotic treatment in an experimental model of acute osteomyelitis.
- To assess the impact of MW therapy on bacterial load in the context of antibiotic treatment for Staphylococcus aureus-induced osteomyelitis in rats.
Main Methods:
- Acute osteomyelitis was induced in the tibias of 40 rats using methicillin-sensitive Staphylococcus aureus (MSSA).
- Rats were allocated to four groups: control (saline), MW therapy alone, systemic cefuroxime alone, and systemic cefuroxime with MW therapy.
- Daily 20-minute MW applications were administered to infected limbs; quantitative culture analysis assessed bacterial burden on day 7.
Main Results:
- Both systemic cefuroxime (Group III) and cefuroxime with MW therapy (Group IV) significantly reduced bacterial counts compared to the control group (p < 0.001).
- A statistically significant difference in bacterial reduction was observed between the cefuroxime-only and cefuroxime plus MW therapy groups (p = 0.033).
- No significant difference in bacterial counts was found between the control group and the MW therapy alone group (p = 0.287).
Conclusions:
- The combination of microwave therapy and systemic antibiotics demonstrated a significant synergistic effect in treating experimental acute osteomyelitis.
- Microwave therapy alone did not show a significant impact on bacterial load in this model.
- Further clinical investigations are necessary to validate the safety and efficacy of this combined treatment modality in human patients.
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