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Local Antibiotic Delivery: Recent Basic and Translational Science Insights in Orthopedics Publisher Pubmed



Hoveidaei AH1 ; Mosalamiaghili S2 ; Sabaghian A3 ; Hajiaghajani S4 ; Farsani AS5 ; Sahebi M6 ; Poursalehian M7 ; Nwankwo BO1, 8 ; Conway JD1
Authors
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Authors Affiliations
  1. 1. International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, United States
  2. 2. Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
  3. 3. School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Howard University Hospital, Department of Orthopaedic Surgery and Rehabilitation, Washington, DC, United States

Source: Bone Published:2025


Abstract

Background: Infections remain a significant challenge in orthopedic settings despite advancements in preventive measures. Antibiotics are the primary defense against infections, but optimal delivery methods to the infection site are still being investigated. This review aims to examine existing approaches for local drug delivery from a basic science perspective. Recent findings: Achieving adequate antibiotic concentration at the infection site is challenging due to compromised vasculature in ischemic conditions. Local administration methods, including antibiotic-loaded carriers such as impregnated bone grafts and various bone substitutes, are being explored as alternatives to systemic antibiotic use. Various materials, including polymethyl methacrylate (PMMA), hydroxyapatite, calcium phosphate/sulfate, bone glass, and hydrogel, are being investigated for local antibiotic delivery. Some of these materials possess inherent antibacterial properties due to their chemical interactions. The selection of appropriate antibiotics, their dosage, release kinetics from the carrier material, physical behavior of the material/graft, and biocompatibility are key areas for further investigation in basic science research. © 2025 Elsevier Inc.
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