Advantages and problems of local antibiotic delivery system in the treatment of osteomyelitis / 中国组织工程研究

ABSTRACT

BACKGROUND: Local antibiotic delivery system can increase local drug concentration, reduce drug toxicity, and increase drug bioavailability, thereby improving the antibacterial efficacy and providing a new method for the long-term treatment of osteomyelitis. OBJECTIVE: To summarize the application progress of various local drug sustained-release systems in the treatment of osteomyelitis, and analyze the current deficiencies and research directions. METHODS: The authors searched for related articles in PubMed, Web of Science, Medline, Wanfang and CNKI databases published from 2007 to 2020. The key words were “osteomyelitis, drug delivery system, antibiotics, PMMA, degradable material” in English; and “osteomyelitis, drug release system, PMMA, degradable materials” in Chinese. There were 221 preliminary inspection articles, and 76 articles were analyzed after screening. RESULTS AND CONCLUSION: Currently, carrier materials commonly used in local drug release systems include degradable materials such as collagen, bioactive glass, and non-degradable materials such as PMMA bone cement. Non-biodegradable antibiotic carriers have been successfully used clinically, but these carriers need to be removed by a second operation, and their early explosive drug release will have a great impact on their efficacy. Therefore, further research on the improvement of non-degradable materials is needed to better improve their efficacy. The local antibiotic delivery system of biodegradable materials can not only continuously deliver drugs at the infection site, but also act as bone filling materials in the early stage. Some degradation products can even create a good bone conduction environment for blood vessels and new bone formation. However, the precise control of drug release in complex systems requires further research.