Advanced platelets rich fibrin (A-PRF) as a sustained release vehicle of antibiotics

The present in-vitro study explored advanced-platelet-rich-fibrin (A-PRF) as sustained-release vehicle for three different antibiotics. 10 ml blood was withdrawn from six patients. Subsequently, 25 mg/ml penicillin (P) and 2.5 mg/ml metronidazole (M) in combination (P + M), 12.5 mg/ml ciprofloxacin (C) or 0.4 mg/ml NaCl were added to blood prior to centrifugation (8min/200g) to prepare A-PRF/P + M, A-PRF/C or A-PRF/NaCl respectively. A-PRFs were examined histologically and by scanning-electron-microscopy (SEM). Volume, length, weight and consistency of A-PRFs were measured and compared. A-PRF/P + M, A-PRF/C or A-PRF/NaCl anti-bacterial properties were examined, using antibiogram assay against Aggregatibacter actinomycetemcomitans (Aa) over 7 days. Release kinetics of A-PRF/P + M or A-PRF/C were characterized, via enzyme-linked-immunosorbent-assay (ELISA). No differences were noted between A-PRF groups regarding volume, length, weight or consistency. A-PRF/C demonstrated denser fibrin histologically and by SEM. Antibiotics augmented A-PRFs preserved anti-bacterial properties over 7 days, with A-PRF/C followed by A-PRF/P + M, demonstrating higher antimicrobial activity against Aa than A-PRF/NaCl (p < 0.05). ELISA demonstrated antibiotics sustained-release, with metronidazole and ciprofloxacin showing decline, in contrast to penicillin, with steady increase in release over 10 days (p < 0.05; repeated-measures-ANOVA). A-PRF could serve as a promising local-delivery vehicle for sustained antibiotic release of ciprofloxacin or penicillin/metronidazole combination over 10 days, highlighting its potential in clinical applications requiring extended antimicrobial action.