• Efficacy and Safety of Antibiotic Impregnated Microporous Nanohydroxyapatite Beads for Chronic Osteomyelitis Treatment: A Multicenter, Open-Label, Prospective Cohort Study

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22/09/2023 by   

Metadata

Document Title

Efficacy and Safety of Antibiotic Impregnated Microporous Nanohydroxyapatite Beads for Chronic Osteomyelitis Treatment: A Multicenter, Open-Label, Prospective Cohort Study

Author

Jiamton C., Apivatgaroon A., Aunaramwat S., Chawalitrujiwong B., Chuaychoosakoon C., Suwannaphisit S., Jirawison C., Iamsumang C., Kongmalai P., Sukvanich P., Nakorn P.N., Ongbumrungphan W., Rattanasumrit P., Tharakulphan S., Thongtanworapat T., Thammarakcharoen F., Srion A., Suwanprateeb J., Chernchujit B.

Affiliations

Institute of Orthopaedics, Lerdsin Hospital, Silom Road, Bang Rak, Bangkok, 10500, Thailand; Queen Savang Vadhana Memorial Hospital, Jerm Jom Phon Road, Chonburi, Tambon Si Racha, Si Racha, 20110, Thailand; Department of Orthopaedics, Faculty of Medicine, Thammasat University, Paholyothin Road, Klong Nueng, Klong Luang, Pathum Thani12121, Thailand; Paholpolpayuhasena Hospital, Sangchuto Road, Pak Phraek, Mueang, Kanchanaburi, 71000, Thailand; Suppasitthiprasong Hospital, Sappasit Road, Nai Mueang, Mueang, Ubon Ratchathani, 34000, Thailand; Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Karnjanavanich Road, Kho Hong, Songkhla, Hat Yai, 90110, Thailand; Bhudasothon Hospital, Marupong Road, Na Mueang, Mueang, Chachoengsao, 24000, Thailand; Lampang Hospital, Phahonyothin Road, Hua Wiang, Mueang, Lampang, 52000, Thailand; Department of Orthopedics, Faculty of Medicine, Srinakharinwirot University, Rangsit-Nakhon Nayok Road, Baan na, Ongkharak, Nakhon Nayok, 26120, Thailand; Hatyai Hospital, Ratthakan, Tambon Hat Yai, Hat Yai, Songkhla, 90110, Thailand; Bhumibol Adulyadej Hospital, Phahonyothin Road, Sai Mai, Bangkok, 10220, Thailand; Khon Kaen Hospital, Sri Chant Road, Mueang, Nai Mueang, Khon Kaen, 40000, Thailand; Pathumtani Hospital, Lat Lum Kaeo Road, Bang Prok, Muang, Pathum Thani, 12000, Thailand; National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), 111 Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani, 12120, Thailand; Thammasat University Center of Excellence in Computational Mechanics and Medical Engineering, Thammasat University, Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani, 12121, Thailand

Type

Article

Source Title

Antibiotics

ISSN

20796382

Year

2023

Volume

12

Issue

6

Open Access

All Open Access, Gold, Green

Publisher

MDPI

DOI

10.3390/antibiotics12061049

Format

PDF

Abstract

Chronic osteomyelitis is still a serious health problem that causes disabling conditions and has an impact on the quality of life. The objective of this study was to determine the clinical efficacy and safety of localized antibiotics delivery via impregnated microporous nanohydroxyapatite (nHA-ATB) beads for chronic osteomyelitis treatment. A total of 62 patients were enrolled in this study. After radical surgical debridement, the bone defect was filled with three types of antibiotics (vancomycin or gentamicin or fosfomycin) impregnated HA beads. The follow-up period was 48 weeks. It was found that the success rate was approximately 98% with a re-infection in only one patient. Quality of life of all patients after treatment improved significantly over time. Systemic exposure to vancomycin and gentamicin after beads implantation was limited and high local antibiotics concentrations were found in wound drainage fluid at 24, 48 and 72 h. Blood biochemistry measurements did not show any nephrotoxic or hepatotoxic effects. 20 adverse events were reported, but 90% of the events were resolved without having to remove the beads and the patients recovered. Satisfactory outcomes were observed in terms of success rate, quality of life and adverse effect. nHA-ATB beads impregnated by vancomycin or gentamicin or fosfomycin could potentially be employed as an alternative product of choice for localized antibiotics delivery in chronic osteomyelitis treatment. ? 2023 by the authors.

License

CC BY

Rights

Authors

Publication Source

WOS

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