Biodegradable vs non-biodegradable antibiotic delivery devices in the treatment of osteomyelitis.

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.

Gentamicin release from commercially-available gentamicin-loaded PMMA bone cements in a prosthesis-related interfacial gap model and their antibacterial efficacy.

Background: Around about 1970, a gentamicin-loaded poly (methylmethacrylate) (PMMA) bone cement brand (Refobacin Palacos R) was introduced to control infection in joint arthroplasties. In 2005, this brand was replaced by two gentamicin-loaded follow-up brands, Refobacin Bone Cement R and Palacos R + G. In addition, another gentamicin-loaded cement brand, SmartSet GHV, was introduced in Europe in 2003.

A biodegradable antibiotic delivery system based on poly-(trimethylene carbonate) for the treatment of osteomyelitis.

Background And Purpose: Many investigations on biodegradable materials acting as an antibiotic carrier for local drug delivery are based on poly(lactide). However, the use of poly(lactide) implants in bone has been disputed because of poor bone regeneration at the site of implantation. Poly(trimethylene carbonate) (PTMC) is an enzymatically degradable polymer that does not produce acidic degradation products.

A surface-eroding antibiotic delivery system based on poly-(trimethylene carbonate).

Biodegradable delivery systems that do not produce acidic compounds during degradation are preferred for local antibiotic delivery in bone infections in order to avoid adverse bone reactions. Poly(trimethylene carbonate) (PTMC) has good biocompatibility, and is such a polymer. The objective of this in vitro study was to explore the suitability of PTMC as an antibiotic releasing polymer for the local treatment of bone infections.