Sulbactam-cefoperazone polyhydroxybutyrate-co-hydroxyvalerate (PHBV) localantibiotic delivery system: In vivo effectiveness and biocompatibility in the treatment of implant-related experimental osteomyelitis

In this study, a novel antibiotic carrier system for use in the treatment o f implant-related and chronic osteomyelitis was developed. Sulbactam-cefope razone was introduced to rods of polyhydroxybutyrate-co-hydroxyvalerate (22 mol % HV, w/w), a member of a family of microbial-origin polymer that is b iodegradable, biocompatible, and osteoconductive due to its piezoelectric p roperty. The antibiotic-loaded carrier was implanted into the infection sit e that was induced by Staphylococcus aureus inoculation into the rabbit tib ia. The effectiveness of this was assessed macroscopically, radiographicall y, bacteriologically, and histopathologically. Findings of infection subsid ed on day 15 and almost complete remission was observed on day 30. The cont rol side that contained antibiotic-free reds, however, worsened. These find ings prompted us to conclude that the novel biodegradable antibiotic carrie r developed in the present study seems to be a promising candidate for use in the treatment of severe bone infection. (C) 1999 John Wiley & Sons, Inc.