title: The Efficacy of Boric Acid Used to Treat Experimental Osteomyelitis Caused by Methicillin-Resistant Staphylococcus aureus: an In Vivo Study.
abstract: We explored the ability of local and systemic applications of boric acid (BA) to reduce the numbers of methicillin-resistant Staphylococcus aureus (MRSA) in a rat model of tibial osteomyelitis (OM), and compared boric acid with vancomycin (V). Implant-associated osteomyelitis was established in 35 rats. After 4 weeks, at which time OM was evident both radiologically and serologically in all animals, the rats were divided into five groups of equal number: group 1, control group (no local application of BA or other medication); group 2, V group; group 3, local BA + V group; group 4, local BA group; and group 5, local + systemic BA group. Serum total antioxidant status, and the levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6, were measured. Pathological changes attributable to bone OM were evaluated using a grading system. Bacterial colony-forming units (CFUs) per gram of bone were counted. The lowest bacterial numbers were evident in group 3, and the bacterial numbers were significantly lower than that of the control group in all four test groups (p < 0.001). Group 3 also had the least severe bone infection (OM score 1.7 ± 1.1, p < 0.05). Upon histological and microbiological evaluation, no significant difference was evident between groups 2 and 3. Total antioxidant levels were significantly different in all treatment groups compared to the control group. Microbiological and histopathological evaluation showed that systemic or local application of BA was effective to treat OM, although supplementary V increased the effectiveness of BA.
authors.affiliation: Ordu University, Ordu, Turkey. dryg@windowslive.com.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Güzel
authors.affiliation: Canakkale University, Canakkale, Turkey.
authors.forename: Umut H
authors.initials: UH
authors.lastname: Golge
authors.affiliation: Canakkale University, Canakkale, Turkey.
authors.forename: Ferdi
authors.initials: F
authors.lastname: Goksel
authors.affiliation: Canakkale University, Canakkale, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Vural
authors.affiliation: Ordu University, Ordu, Turkey.
authors.forename: Muruvvet
authors.initials: M
authors.lastname: Akcay
authors.affiliation: Canakkale University, Canakkale, Turkey.
authors.forename: Sait
authors.initials: S
authors.lastname: Elmas
authors.affiliation: Canakkale University, Canakkale, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Turkon
authors.affiliation: Canakkale University, Canakkale, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Unver
mesh_terms: D000818:Animals; D001888:Boric Acids / Q000494:pharmacology*; D004195:Disease Models, Animal; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000378:metabolism*; D010019:Osteomyelitis / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D051381:Rats; D017208:Rats, Wistar; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D001888:Boric Acids; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; C032688:boric acid
keywords: Adjunctive therapy; Boric acid; IL-6; Osteomyelitis; TNF-alpha; Vancomycin