Document Detail


Biodegradable vs non-biodegradable antibiotic delivery devices in the treatment of osteomyelitis.
MedLine Citation:
PMID:  23289645     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Chronic osteomyelitis, or bone infection, is a major worldwide cause of morbidity and mortality, as it is exceptionally hard to treat due to patient and pathogen-associated factors. Successful treatment requires surgical debridement together with long-term, high antibiotic concentrations that are best achieved by local delivery devices, either made of degradable or non-degradable materials.
AREAS COVERED: Non-degradable delivery devices are frequently constituted by polymethylmethacrylate-based carriers. Drawbacks are the need to remove the carrier (as the carrier itself may provide a substratum for bacterial colonization), inefficient release kinetics and incompatibility with certain antibiotics. These drawbacks have led to the quest for degradable alternatives, but also devices made of biodegradable calcium sulphate, collagen sponges, calcium phosphate or polylactic acids have their specific disadvantages.
EXPERT OPINION: Antibiotic treatment of osteomyelitis with the current degradable and non-degradable delivery devices is effective in the majority of cases. Degradable carriers have an advantage over non-degradable carriers that they do not require surgical removal. Synthetic poly(trimethylene carbonate) may be preferred in the future over currently approved lactic/glycolic acids, because it does not yield acidic degradation products. Moreover, degradable poly(trimethylene carbonate) yields a zero-order release kinetics that may not stimulate development of antibiotic-resistant bacterial strains due to the absence of long-term, low-concentration tail-release.
Authors:
Otto S Kluin; Henny C van der Mei; Henk J Busscher; Daniëlle Neut
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Publication Detail:
Type:  Journal Article; Review     Date:  2013-01-06
Journal Detail:
Title:  Expert opinion on drug delivery     Volume:  10     ISSN:  1744-7593     ISO Abbreviation:  Expert Opin Drug Deliv     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-15     Completed Date:  2013-05-20     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  101228421     Medline TA:  Expert Opin Drug Deliv     Country:  England    
Other Details:
Languages:  eng     Pagination:  341-51     Citation Subset:  IM    
Affiliation:
Department of Biomedical Engineering, W. J. Kolff Institute, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen , The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Absorbable Implants*
Animals
Anti-Bacterial Agents / administration & dosage*
Dioxanes
Drug Delivery Systems*
Humans
Lactic Acid
Osteomyelitis / drug therapy*,  microbiology
Polymers
Polymethyl Methacrylate
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Dioxanes; 0/Polymers; 26100-51-6/poly(lactic acid); 31852-84-3/polytrimethylene carbonate; 50-21-5/Lactic Acid; 9011-14-7/Polymethyl Methacrylate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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