Current and emerging biomaterials for targeted drug delivery in osteomyelitis management

Osteomyelitis is a chronic bone infection that frequently necessitates extended antibiotic treatment and, in severe instances, surgical procedures. Conventional systemic antibiotic delivery is constrained by inadequate drug concentrations at the infection site, potential toxicity, and the development of antibiotic resistance. The development of targeted drug delivery systems, especially those employing advanced biomaterials, has received considerable attention as a means to enhance treatment efficacy, minimize systemic side effects, and address bacterial resistance mechanisms. This review analyzes the existing biomaterials employed in targeted drug delivery for osteomyelitis treatment, focusing on hydrogels, nanoparticles, microspheres, and bioactive scaffolds, while also assessing emerging technologies like stimuli-responsive and biofunctionalized carriers. This review summarizes recent advancements in biomaterial-based therapies and evaluates their clinical potential, aiming to provide insight into the future of osteomyelitis treatment while highlighting opportunities for the design of more effective and patient-specific therapies.