title: Comparison of Borate Bioactive Glass and Calcium Sulfate as Implants for the Local Delivery of Teicoplanin in the Treatment of Methicillin-Resistant Staphylococcus aureus-Induced Osteomyelitis in a Rabbit Model.
abstract: There is growing interest in biomaterials that can cure bone infection and also regenerate bone. In this study, two groups of implants composed of 10% (wt/wt) teicoplanin (TEC)-loaded borate bioactive glass (designated TBG) or calcium sulfate (TCS) were created and evaluated for their ability to release TEC in vitro and to cure methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis in a rabbit model. When immersed in phosphate-buffered saline (PBS), both groups of implants provided a sustained release of TEC at a therapeutic level for up to 3 to 4 weeks while they were gradually degraded and converted to hydroxyapatite. The TBG implants showed a longer duration of TEC release and better retention of strength as a function of immersion time in PBS. Infected rabbit tibiae were treated by debridement, followed by implantation of TBG or TCS pellets or intravenous injection with TEC, or were left untreated. Evaluation at 6 weeks postimplantation showed that the animals implanted with TBG or TCS pellets had significantly lower radiological and histological scores, lower rates of MRSA-positive cultures, and lower bacterial loads than those preoperatively and those of animals treated intravenously. The level of bone regeneration was also higher in the defects treated with the TBG pellets. The results showed that local TEC delivery was more effective than intravenous administration for the treatment of MRSA-induced osteomyelitis. Borate glass has the advantages of better mechanical strength, more desirable kinetics of release of TEC, and a higher osteogenic capacity and thus could be an effective alternative to calcium sulfate for local delivery of TEC.
authors.affiliation: Department of Orthopedics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Wei-Tao
authors.initials: WT
authors.lastname: Jia
authors.affiliation: Corning Incorporated, Corning, New York, USA.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.affiliation: Institute of Bioengineering and Information Technology Materials, Tongji University, Shanghai, China.
authors.forename: Wen-Hai
authors.initials: WH
authors.lastname: Huang
authors.affiliation: Department of Orthopedics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China zhang_changqing@hotmail.com rahaman@mst.edu.
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Zhang
authors.affiliation: Department of Materials Science and Engineering, Missouri University of Science and Technology, Rolla, Missouri, USA zhang_changqing@hotmail.com rahaman@mst.edu.
authors.forename: Mohamed N
authors.initials: MN
authors.lastname: Rahaman
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001896:Boron Compounds / Q000737:chemistry / Q000494:pharmacology*; D002133:Calcium Sulfate / Q000737:chemistry / Q000494:pharmacology*; D004195:Disease Models, Animal; D004337:Drug Carriers / Q000138:chemical synthesis / Q000494:pharmacology*; D004343:Drug Implants / Q000138:chemical synthesis / Q000494:pharmacology*; D017886:Durapatite / Q000737:chemistry; D005260:Female; D005898:Glass / Q000737:chemistry; D015552:Injections, Intralesional; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D017334:Teicoplanin / Q000494:pharmacology; D013977:Tibia / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001896:Boron Compounds; D004337:Drug Carriers; D004343:Drug Implants; D017334:Teicoplanin; D017886:Durapatite; D002133:Calcium Sulfate