Therapeutics and delivery vehicles for local treatment of osteomyelitis.
Therapeutics and delivery vehicles for local treatment of osteomyelitis.
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DOI：
10.1002/jor.24689
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Priddy LB
中科院分区：
文献类型：
--
作者：
Cobb LH;McCabe EM;Priddy LB
骨髓炎或骨感染是骨科的主要并发症，可能导致住院时间延长，植入物失效，在更极端的情况下，截肢受影响的肢体。这种疾病的典型治疗包括外科清创术，然后是长期全身性抗生素给药，这有助于耐药性细菌的发展，并且根除具有挑战性的生物膜形成病原体（包括金黄色葡萄球菌-骨髓炎的最常见原因）的能力有限。通过传统骨水泥局部递送高剂量抗生素可以减少抗生素的全身副作用。尽管如此，对抗生素的爆发释放（然后亚治疗剂量）的日益关注，沿着不可降解的骨水泥生物材料的微生物定殖，进一步加剧了抗生素耐药性，并突出了设计替代性抗微生物治疗剂和局部递送载体的需要，其具有针对特别是生物膜形成的耐药性细菌的增加的功效。此外，关于标准化制剂方案和经验证的测定来预测治疗药物对多种细菌菌株的功效的指导有限。理想情况下，抗微生物策略将是高度特异性的，同时表现出广谱的杀菌活性。重点是金黄色葡萄球菌感染，这篇综述讨论了新的治疗方法和局部给药载体的疗效，作为传统抗生素治疗方案的替代品。这篇综述的目的是讨论这些组成部分与长骨骨髓炎，并鼓励积极的方向，为今后的研究工作。
Osteomyelitis, or the infection of bone, presents a major complication in orthopedics and may lead to prolonged hospital visits, implant failure, and in more extreme cases, amputation of affected limbs. Typical treatment for this disease involves surgical debridement followed by long-term, systemic antibiotic administration, which contributes to the development of antibiotic-resistant bacteria and has limited ability to eradicate challenging biofilm-forming pathogens including Staphylococcus aureus—the most common cause of osteomyelitis. Local delivery of high doses of antibiotic via traditional bone cements can reduce systemic side effects of antibiotic. Nonetheless, growing concerns over burst release (then subtherapeutic dose) of antibiotic, along with microbial colonization of the nondegradable cement biomaterial, further exacerbate antibiotic resistance and highlight the need to engineer alternative antimicrobial therapeutics and local delivery vehicles with increased efficacy against, in particular, biofilm-forming, antibiotic-resistant bacteria. Furthermore, limited guidance exists regarding both standardized formulation protocols and validated assays to predict efficacy of a therapeutic against multiple strains of bacteria. Ideally, antimicrobial strategies would be highly specific while exhibiting a broad spectrum of bactericidal activity. With a focus on Staphylococcus aureus infection, this review addresses the efficacy of novel therapeutics and local delivery vehicles, as alternatives to the traditional antibiotic regimens. The aim of this review is to discuss these components with regards to long bone osteomyelitis, and to encourage positive directions for future research efforts.
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影响因子：
4.6
作者：
Brackman G;Breyne K;De Rycke R;Vermote A;Van Nieuwerburgh F;Meyer E;Van Calenbergh S;Coenye T
通讯作者：
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影响因子：
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影响因子：
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作者：
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4.9
作者：
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通讯作者：
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DOI：
10.1002/jbmr.3055
发表时间：
2017-05
期刊：
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
影响因子：
--
作者：
de Mesy Bentley KL;Trombetta R;Nishitani K;Bello-Irizarry SN;Ninomiya M;Zhang L;Chung HL;McGrath JL;Daiss JL;Awad HA;Kates SL;Schwarz EM
通讯作者：
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