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Treatment of Staphylococcus aureus-induced chronic osteomyelitis with bone-like hydroxyapatite/poly amino acid loaded with rifapentine microspheres

Authors Yan L, Jiang D, Cao Z, Wu J, Wang X, Wang Z, Li Y, Yi Y

Received 12 March 2015

Accepted for publication 5 May 2015

Published 16 July 2015 Volume 2015:9 Pages 3665—3676

DOI https://doi.org/10.2147/DDDT.S84486

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Shu-Feng Zhou


Ling Yan,1 Dian-Ming Jiang,2 Zhi-Dong Cao,2 Jun Wu,2 Xin Wang,3 Zheng-Long Wang,4 Ya-Jun Li,5 Yong-Fen Yi1

1
Department of Pathology, College of Basic Medicine, 2Department of Orthopaedic Surgery, The First Affiliated Hospital, 3Pediatric Hospital, 4Department of Cardiology, The First Affiliated Hospital, 5Department of Radiology, College of Basic Medicine, Chongqing Medical University, Chongqing, People’s Republic of China

Purpose: The purpose of this study was to investigate the curative effect of bone-like hydroxyapatite/poly amino acid (BHA/PAA) as a carrier for poly(lactic-co-glycolic acid)-coated rifapentine microsphere (RPM) in the treatment of rabbit chronic osteomyelitis induced by Staphylococcus aureus.
Methods: RPM was prepared through an oil-in-water emulsion solvent evaporation method, and RPM was combined with BHA/PAA to obtain drug-loaded, slow-releasing materials. Twenty-six New Zealand white rabbits were induced to establish the animal model of chronic osteomyelitis. After debridement, the animals were randomly divided into three groups (n=8): the experimental group (with RPM-loaded BHA/PAA), the control group (with BHA/PAA), and the blank group. The RPM-loaded BHA/PAA was evaluated for antibacterial activity, dynamics of drug release, and osteogenic ability through in vitro and in vivo experiments.
Results: In vitro, RPM-loaded BHA/PAA released the antibiotics slowly, inhibiting the bacterial growth of S. aureus for up to 5 weeks. In vivo, at week 4, the bacterial colony count was significantly lower in the experimental group than in the control and blank groups (P<0.01). At week 12, the chronic osteomyelitis was cured and the bone defect was repaired in the experimental group, whereas the infection and bone defect persisted in the control and blank groups.
Conclusion: In vitro and in vivo experiments demonstrated that RPM-loaded BHA/PAA effectively cured S. aureus-induced chronic osteomyelitis. Therefore, BHA/PAA has potential value as a slow-releasing material in clinical setting. Further investigation is needed to determine the optimal dosage for loading rifapentine.

Keywords: osteomyelitis, antibiotics-loaded bone materials, bone defect, antimicrobial, osteoconduction

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