Effective treatment of osteomyelitis with biodegradable microspheres in a rabbit model.
Biodegradable microspheres were manufactured from a high molecular weight copolymer of 50% lactic and 50% glycolic acid and the antibiotic tobramycin. It was hypothesized that the microspheres would be more effective than polymethylmethacrylate beads in the local delivery of tobramycin and that the microspheres would not inhibit bone healing. Osteomyelitis was established in 40 New Zealand White rabbits using Staphylococcus aureus. All animals had irrigation and debridement of the infected radii four weeks after inoculation and were divided into five treatment groups: debridement alone, microspheres alone, microspheres containing tobramycin plus parenteral treatment with cefazolin, polymethylmethacrylate beads containing tobramycin plus parenteral cefazolin, and parenteral cefazolin. All animals were sacrificed after 4 weeks of treatment. The group treated with microspheres plus parenteral antibiotics was the only group to have a significantly higher percentage of animals without bacteria after 4 weeks of treatment when compared with the control group. Additionally, the animals treated with microspheres had a higher degree of bone healing in the defect than the animals treated with bone cement. The most effective treatment was biodegradable microspheres combined with parenteral antibiotic in this rabbit osteomyelitis model.
Ambrose
Catherine G
CG
Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston, Houston, TX 77030, USA. Catherine.G.Ambrose@uth.tmc.edu
Clyburn
Terry A
TA
Louden
Keith
K
Joseph
John
J
Wright
John
J
Gulati
Poonam
P
Gogola
Gloria R
GR
Mikos
Antonios G
AG
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001672:Biocompatible Materials; D002437:Cefazolin / Q000008:administration & dosage; D004195:Disease Models, Animal; D004337:Drug Carriers; D007263:Infusions, Parenteral; D019344:Lactic Acid; D008297:Male; D008863:Microspheres; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D011100:Polyglycolic Acid; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011108:Polymers; D019904:Polymethyl Methacrylate; D011817:Rabbits; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D013203:Staphylococcal Infections / Q000188:drug therapy; D014031:Tobramycin / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D004337:Drug Carriers; D011108:Polymers; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D019904:Polymethyl Methacrylate; D002437:Cefazolin; D014031:Tobramycin