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osteomyelitis; delivery

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https://www.readbyqxmd.com/read/28735655/an-intramedullary-nail-coated-with-antibiotic-and-growth-factor-nanoparticles-an-individualized-state-of-the-art-treatment-for-chronic-osteomyelitis-with-bone-defects
#1
Roberto Berebichez-Fridman, Pablo Montero-Olvera, Ricardo Gómez-García, Enrique Berebichez-Fastlicht
Among various infections, chronic osteomyelitis is one of the most challenging in terms of treatment. This infection is more common among patients with open fractures and those who have undergone elective orthopedic procedures. The treatment of osteomyelitis requires high antibiotic doses and an aggressive and multifaceted surgical approach. The use of parenteral antibiotics alone, without debridement, is not sufficiently effective, due to the formation of sequestra and the low vascularity of the affected area...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28644392/development-of-bone-targeting-drugs
#2
REVIEW
Molly Stapleton, Kazuki Sawamoto, Carlos J Alméciga-Díaz, William G Mackenzie, Robert W Mason, Tadao Orii, Shunji Tomatsu
The skeletal system, comprising bones, ligaments, cartilage and their connective tissues, is critical for the structure and support of the body. Diseases that affect the skeletal system can be difficult to treat, mainly because of the avascular cartilage region. Targeting drugs to the site of action can not only increase efficacy but also reduce toxicity. Bone-targeting drugs are designed with either of two general targeting moieties, aimed at the entire skeletal system or a specific cell type. Most bone-targeting drugs utilize an affinity to hydroxyapatite, a major component of the bone matrix that includes a high concentration of positively-charged Ca(2+)...
June 23, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28599795/metallic-nanoparticles-to-eradicate-bacterial-bone-infection
#3
Shahnaz Qadri, Yousef Haik, Eric Mensah-Brown, Ghada Bashir, Maria J Fernandez-Cabezudo, Basel K Al-Ramadi
Treatment of osteomyelitis by conventional antibiotics has proven to be challenging due to limited accessibility to this unique location. Inorganic routes against bacterial infection have been reported for external and topical applications, however in vivo application of these antimicrobials has not been fully explored. Targeted delivery of metallic nanoparticles with inherent antimicrobial activity represents an alternative means of overcoming the challenges posed by multidrug-resistant bacteria and may potentially reduce overall morbidity...
June 7, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/28566002/a-two-stage-cold-isostatic-pressing-and-gelling-approach-for-fabricating-a-therapeutically-loaded-amorphous-calcium-polyphosphate-local-delivery-system
#4
Patricia Comeau, Mark Filiaggi
Local delivery systems have taken on a greater clinical focus for osteomyelitis therapy owing to their ability to overcome many disadvantages of systemic delivery. This study reports for the first time the capacity to fabricate strontium- and vancomycin-doped calcium polyphosphate beads using a two-stage cold isostatic pressing and gelling approach. The fabricated beads were of uniform shape and diameter, and upon gelling exhibited reduced porosity. Of greatest significance in the subsequent in vitro study was the improvement of bead long-term structural stability upon vancomycin incorporation; a characteristic that further encourages the extended release of therapeutically relevant levels of antibiotic...
January 1, 2017: Journal of Biomaterials Applications
https://www.readbyqxmd.com/read/28447299/vancomycin-loaded-hpmc-microparticles-embedded-within-injectable-thermosensitive-chitosan-hydrogels
#5
M Mahmoudian, F Ganji
Antibiotic use is an essential method for the treatment of bacterial infections. In certain cases, antibiotics are not effective because of the distribution problems caused by physiological barriers in the body. Such problems are thought to be minimized by development of sustained release systems which involve implantation of antibiotic loaded polymeric systems directly to the site of infection. In this work, a new composite vancomycin hydrochloride release system based on HPMC microparticles and chitosan/glycerophosphate (Ch/Gp) thermosensitive hydrogel was designed for the aim of local treatment of osteomyelitis...
May 2017: Progress in biomaterials
https://www.readbyqxmd.com/read/28396232/treatment-of-osteomyelitis-a-case-for-disruption-of-the-affected-adjacent-periosteum
#6
John W Hudson, Austin P Daly, Michael Foster
PURPOSE: To evaluate the response of mandibular osteomyelitis treated by surgical decortication with disruption of the affected adjacent periosteum in concert with long-term targeted antibiotic therapy. The hypothesis is that, by removing the buccal cortical plate and disrupting the hypertrophically inflamed adjacent periosteum, the medullary bone will be brought in contact with bleeding tissue and circulating immunologic factors and antibiotics, which will promote definitive resolution...
March 18, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28336039/the-antibiotic-nail-in-the-treatment-of-long-bone-infection-technique-and-results
#7
REVIEW
Kenneth L Koury, John S Hwang, Michael Sirkin
Antibiotic cement nails provide a useful and relatively simple technique to treat intramedullary osteomyelitis of the long bones. These devices provide stability as well as local, targeted antibiotics, which are both critical aspects of osteomyelitis management. Additionally, the use of a threaded core is a critical component of successful cement nail assembly. With adherence to the simple principles outlined in this review, surgeons can expect reliably good results using these drug-delivery implants.
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28331309/in-vitro-and-in-vivo-drug-release-and-antibacterial-properties-of-the-novel-vancomycin-loaded-bone-like-hydroxyapatite-poly-amino-acid-scaffold
#8
Zhidong Cao, Dianming Jiang, Ling Yan, Jun Wu
Antibiotic-loaded carriers were developed to fill cavities and locally deliver antibiotics following implantation. However, the most commonly used antibiotic carrier, polymethyl methacrylate (PMMA), has many disadvantages including that it does not promote bone regeneration or conduction. Vancomycin-loaded bone-like hydroxyapatite/poly amino acid (V-BHA/PAA) was successfully fabricated by a homogeneous method, certified as biosafe and known to promote osteogenesis. To evaluate its drug-release features, the quantity of the vancomycin in the elution was obtained every 2 days after in vitro simulated body fluid immersion...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28243084/efficient-induction-of-antimicrobial-activity-with-vancomycin-nanoparticle-loaded-poly-trimethylene-carbonate-localized-drug-delivery-system
#9
Yang Zhang, Ruo-Jia Liang, Jiao-Jiao Xu, Li-Feng Shen, Jian-Qing Gao, Xu-Ping Wang, Na-Ni Wang, Dan Shou, Ying Hu
Surgery and the local placement of an antibiotic are the predominant therapies to treat chronic osteomyelitis. Vancomycin-loaded N-trimethyl chitosan nanoparticles (VCM/TMC NPs) as a potential drug delivery system have high intracellular penetration and effective intracellular antibacterial activity. This study investigated the effects of a biocompatible material, poly(trimethylene carbonate) (PTMC), to increase the sustained effectiveness of an intracellular antibiotic and its potential application in antibiotic delivery...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28121436/design-synthesis-and-antimicrobial-evaluation-of-a-novel-bone-targeting-bisphosphonate-ciprofloxacin-conjugate-for-the-treatment-of-osteomyelitis-biofilms
#10
Parish P Sedghizadeh, Shuting Sun, Adam F Junka, Eric Richard, Keivan Sadrerafi, Susan Mahabady, Neema Bakhshalian, Natalia Tjokro, Marzenna Bartoszewicz, Monika Oleksy, Patrycja Szymczyk, Mark W Lundy, Jeffrey D Neighbors, R Graham G Russell, Charles E McKenna, Frank H Ebetino
Osteomyelitis is a major problem worldwide and is devastating due to the potential for limb-threatening sequelae and mortality. Osteomyelitis pathogens are bone-attached biofilms, making antibiotic delivery challenging. Here we describe a novel osteoadsorptive bisphosphonate-ciprofloxacin conjugate (BV600022), utilizing a "target and release" chemical strategy, which demonstrated a significantly enhanced therapeutic index versus ciprofloxacin for the treatment of osteomyelitis in vivo. In vitro antimicrobial susceptibility testing of the conjugate against common osteomyelitis pathogens revealed an effective bactericidal profile and sustained release of the parent antibiotic over time...
March 23, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28106379/sustainable-release-of-vancomycin-from-silk-fibroin-nanoparticles-for-treating-severe-bone-infection-in-rat-tibia-osteomyelitis-model
#11
Negar Hassani Besheli, Fatemeh Mottaghitalab, Masoud Eslami, Mahdi Gholami, Subhas C Kundu, David L Kaplan, Mehdi Farokhi
The successful treatment of bone infections is a major challenge in the field of orthopedics. There are some common methods for treating bone infections, including systemic antibiotic administration, local nondegradable drug vehicles, and surgical debridement, and each of these approaches has advantages and disadvantages. In the present study, the antibiotic vancomycin (VANCO) was loaded in silk fibroin nanoparticles (SFNPs) and the complexes were then entrapped in silk scaffolds to form sustained drug delivery systems...
February 6, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28053381/a-simple-method-for-fashioning-an-antibiotic-impregnated-cemented-rod-for-intramedullary-placement-in-infected-non-union-of-long-bones
#12
Ajay Bharti, Umesh Kumar Saroj, Vineet Kumar, Sanjay Kumar, Balram Ji Omar
The intramedullary insertion of antibiotic impregnated PMMA rods, beads or nails are widely used and accepted modality of treatment for chronic osteomyelitis of long bones. But at times it becomes difficult to insert and remove these antibiotic delivery systems owing to narrowed medullary canals. Here we present a technique for preparing PMMA rods with diameter ranging from 6 mm to 3 mm. These rods could easily be placed in narrow intramedullary canal of long bones with chronic osteomyelitis or infected non-union...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27894964/approach-to-osteomyelitis-treatment-with-antibiotic-loaded-pmma
#13
REVIEW
Zhang Wentao, Guangyu Lei, Yang Liu, Wei Wang, Tao Song, Jinzhu Fan
BACKGROUND: To reduce the incidence of osteomyelitis infection, local antibiotic impregnated delivery systems are commonly used as a promising and effective approach to deliver high antibiotic concentrations at the infection site. OBJECTIVE: The objective of this review was to provide a literature review regarding approach to osteomyelitis treatment with antibiotic loaded PMMA. STUDY DESIGN: Literature study regarding osteomyelitis treatment with antibiotic loaded carriers using key terms Antibiotic, osteomyelitis, biodegradable PMMA through published articles...
January 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/27822001/osteomyelitis-recent-advances-in-pathophysiology-and-therapeutic-strategies
#14
REVIEW
Mitchell C Birt, David W Anderson, E Bruce Toby, Jinxi Wang
This review article summarizes the recent advances in pathogenic mechanisms and novel therapeutic strategies for osteomyelitis, covering both periprosthetic joint infections and fracture-associated bone infections. A better understanding of the pathophysiology including the mechanisms for biofilm formation has led to new therapeutic strategies for this devastating disease. Research on novel local delivery materials with appropriate mechanical properties, lower exothermicity, controlled release of antibiotics, and absorbable scaffolding for bone regeneration is progressing rapidly...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27713087/a-nanovehicle-developed-for-treating-deep-seated-bacteria-via-using-low-dose-x-ray
#15
Chien-Lin Pan, Ming-Hong Chen, Fu-I Tung, Tse-Ying Liu
Many non-antibiotic strategies, such as photocatalysis and photodynamic therapy, have been proposed to inhibit and/or kill bacteria. However, these approaches still have drawbacks such as insufficient bacterial specificity and the limited penetration depth of ultraviolet and near-infrared light. To overcome these limitations, we developed a bacteria-specific anti-bacterial technique via using low-dose X-ray. Graphene oxide quantum dots (GQDs, a multifunctional vehicle) conjugated with vancomycin (Van, a bacteria-targeting ligand) were assembled with Protoporphyrin IX (PpIX, a photo/radiation sensitizer) to yield a novel Van-GQDs/PpIX complex that specifically attached to Escherichia coli and efficiently generated intracellular reactive oxygen species following X-ray activation...
October 3, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27693717/understanding-osteomyelitis-and-its-treatment-through-local-drug-delivery-system
#16
REVIEW
Samit Kumar Nandi, Samiran Bandyopadhyay, Piyali Das, Indranil Samanta, Prasenjit Mukherjee, Subhasis Roy, Biswanath Kundu
Chronic osteomyelitis is a major challenge in bone surgery. Conventional use of antibiotics is not an effective way to control the malaise due to so many reasons. Determination of optimal treatment strategy becomes difficult for the orthopaedic surgeons and as a consequence, the patients suffer not only from therapeutic failure but also due to adverse side effects of antibiotics and financial loss due to additional stay at hospitals. A wide application of carrier systems, as a medium for local delivery of antibiotics, is being used experimentally and clinically for the treatment of osteomyelitis...
December 2016: Biotechnology Advances
https://www.readbyqxmd.com/read/27678329/pharmacokinetics-of-gentamicin-eluted-from-a-regenerating-bone-graft-substitute-in-vitro-and-clinical-release-studies
#17
M Stravinskas, P Horstmann, J Ferguson, W Hettwer, M Nilsson, S Tarasevicius, M M Petersen, M A McNally, L Lidgren
OBJECTIVES: Deep bone and joint infections (DBJI) are directly intertwined with health, demographic change towards an elderly population, and wellbeing.The elderly human population is more prone to acquire infections, and the consequences such as pain, reduced quality of life, morbidity, absence from work and premature retirement due to disability place significant burdens on already strained healthcare systems and societal budgets.DBJIs are less responsive to systemic antibiotics because of poor vascular perfusion in necrotic bone, large bone defects and persistent biofilm-based infection...
September 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/27587217/-progress-of-different-drug-delivery-route-of-vancomycin-for-the-treatment-of-chronic-osteomyelitis
#18
Y Z Long, Z X Zhu, Y Yu, S M Zhang
Chronic osteomyelitis (COM) is an infectious disease caused by methicillin-resistant Staphylococcus aureus (MRSA), the main characteristics of COM including local dead bone formation, soft tissue infection, and repeatedly attacks. As a sensitive antibiotic, vancomycin plays an important role in the therapy of COM caused by MRSA. Currently, drug treatment is divided into systemic and topical, systemic medication is given priority to intravenous drug delivery; local drug application including local delivery device and local antibiotics lavage and regional arterial perfusion...
September 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27520562/bioactive-natural-polymeric-scaffolds-loaded-with-ciprofloxacin-for-treatment-of-osteomyelitis
#19
Amany A Mostafa, Mayyada M H El-Sayed, Azza A Mahmoud, Amira M Gamal-Eldeen
Local delivery of antibiotic into injured bone is a demand. In this work, different scaffolds of chitosan (C) with or without bioactive glass (G) were prepared using the freeze-drying technique in 2:1, 1:1, and 1:2 weight ratios. Chitosan scaffolds and selected formulas of chitosan to bioglass were loaded with ciprofloxacin in 5%, 10%, and 20% w/w. Scaffold morphology showed an interconnected porous structure, where the glass particles were homogeneously dispersed in the chitosan matrix. The kinetic study confirmed that the scaffold containing 1:2 weight ratio of chitosan to glass (CG12) showed optimal bioactivity with good compromise between Ca and P uptake capacities and Si release rate...
August 12, 2016: AAPS PharmSciTech
https://www.readbyqxmd.com/read/27472197/local-intramedullary-delivery-of-vancomycin-can-prevent-the-development-of-long-bone-staphylococcus-aureus-infection
#20
Catherine Loc-Carrillo, Caroline Wang, Ahranee Canden, Michael Burr, Jayant Agarwal
Current treatments for methicillin-resistant Staphylococcus aureus (MRSA) infections require intravenously delivered vancomycin; however, systemically delivered vancomycin has its problems. To determine the feasibility and safety of locally delivering vancomycin hydrochloride (~25 mg/Kg) to the medullary canal of long bones, we conducted a pharmacokinetics study using a rat tibia model. We found that administering the vancomycin intraosseously resulted in very low concentrations of vancomycin in the blood plasma and the muscle surrounding the tibia, reducing the risk for systemic toxicity, which is often seen with traditional intravenous administration of vancomycin...
2016: PloS One
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