Implantable antimicrobial biomaterials for local drug delivery in bone infection models

Acta Biomater. 2019 Jul 15:93:2-11. doi: 10.1016/j.actbio.2019.01.015. Epub 2019 Jan 14.

Abstract

Increased use of implantable biomedical devices demonstrates their potential in treating a wide variety of ailments and disorders in bone trauma and orthopaedic, reconstructive, and craniofacial applications. However, the number of cases involving implant failure or malfunction due to bacterial infection have also increased in recent years. Implanted devices can facilitate the growth of bacteria as these micro-organisms have the potential to adhere to the implant and grow and develop to form biofilms. In an effort to better understand and mitigate these occurrences, biomaterials containing antimicrobial agents that can be released or presented within the local microenvironment have become an important area of research. In this review, we discuss critical factors that regulate antimicrobial therapy to sites of bone infection, such as key biomolecular considerations and platforms for delivery, as well as current in vivo models and current advances in the field. STATEMENT OF SIGNIFICANCE: This review outlines the important factors that are taken into consideration for the development of biomaterials for local delivery of therapeutics to the site of bone infections. An overview of important criteria for development of this model (such as type of bone defect, antimicrobial therapeutic, and delivery vehicle) are provided, along with current research that utilizes these considerations. Additionally, this review highlights recent clinical trials that have utilized antimicrobial therapeutics for treatment of osteomyelitis.

Keywords: Antimicrobial; Bone defect; Implantable biomaterials; Local delivery; Orthopaedic infection.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Anti-Infective Agents / therapeutic use*
  • Bacteria / growth & development*
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • Bacterial Infections / pathology
  • Bacterial Physiological Phenomena / drug effects*
  • Biocompatible Materials / therapeutic use*
  • Biofilms / drug effects*
  • Bone Diseases, Infectious / drug therapy*
  • Bone Diseases, Infectious / microbiology
  • Bone Diseases, Infectious / pathology
  • Drug Implants / therapeutic use
  • Humans

Substances

  • Anti-Infective Agents
  • Biocompatible Materials
  • Drug Implants