title: Chitosan coating to enhance the therapeutic efficacy of calcium sulfate-based antibiotic therapy in the treatment of chronic osteomyelitis.
abstract: We demonstrate that coating calcium sulfate with deacetylated chitosan enhances the elution profile of daptomycin by prolonging the period during which high concentrations of antibiotic are released. Coatings reduced initial bolus release of daptomycin by a factor of 10 to approximately 1000 µg/ml, and levels remained above 100 µg/ml for up to 10 days. Chitosan-coated and uncoated calcium sulfate implants with and without 15% daptomycin were evaluated in an experimental model of staphylococcal osteomyelitis through bacteriology scores, radiology, histopathology, and Gram staining. Significant reduction in bacteriology scores was observed for implants containing daptomycin and coated with chitosan compared with all the other groups. We confirm that the use of chitosan-coated calcium sulfate beads for local antibiotic delivery can be correlated with an improved therapeutic outcome following surgical debridement in the treatment of chronic osteomyelitis.
authors.affiliation: Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Beenken
authors.affiliation: Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA.
authors.forename: James K
authors.initials: JK
authors.lastname: Smith
authors.affiliation: Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Skinner
authors.affiliation: Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Mclaren
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: William
authors.initials: W
authors.lastname: Bellamy
authors.affiliation: Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: M Johannes
authors.initials: MJ
authors.lastname: Gruenwald
authors.affiliation: Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Horace J
authors.initials: HJ
authors.lastname: Spencer
authors.affiliation: Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA jjnnings@memphis.edu.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Jennings
authors.affiliation: Department of Biomedical Engineering, University of Memphis, Memphis, TN, USA.
authors.forename: Warren O
authors.initials: WO
authors.lastname: Haggard
authors.affiliation: Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Smeltzer
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002133:Calcium Sulfate / Q000737:chemistry; D048271:Chitosan / Q000737:chemistry*; D002908:Chronic Disease; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D017576:Daptomycin / Q000008:administration & dosage; D004195:Disease Models, Animal; D016503:Drug Delivery Systems; D008297:Male; D008422:Materials Testing; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D019904:Polymethyl Methacrylate / Q000737:chemistry; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D019904:Polymethyl Methacrylate; D048271:Chitosan; D017576:Daptomycin; D002133:Calcium Sulfate
keywords: Calcium sulfate; bone; chitosan; daptomycin; infection; local drug delivery; osteomyelitis