Comparison of the therapeutic efficacy of antibiotic-loaded polymeric tissue scaffold and bone cement in the regeneration of infected bone tissue

Background Local antibiotic applications have been used in osteomyelitis as an adjunctive treatment method. Biodegradable materials are also used for the same purpose by adding antibiotics. The fact that it does not require additional surgery to be removed is an important advantage. The current study is therefore intended to develop a biodegradable drug-loaded polymeric scaffold with a good antibiotic release that can be an alternative to antibiotic-impregnated bone cement. Methods A tissue scaffold containing poly (2-hydroxyethyl methacrylate) (PHEMA) was prepared in our laboratory and loaded with Ertapenem and Daptomycin(E&D) antibiotics. To evaluate drug release kinetics, the absorbance values of the scaffold loaded with E&D were measured with the spectrometer. For microbiological tests, (E&D) impregnated cement and scaffold, as well as the control scaffold and cement samples were investigated for their antibacterial activities on Staphylococcus aureus and Klebsiella pneumoniae strains using the disc diffusion method. Results The Daptomycin zone diameter in S. aureus ATCC strain was 17 mm, 24 mm for scaffold, and 22 mm for cement. Scaffold was found to be more effective than cement against S. aureus strain. On K. pneumoniae ATCC strain, it was found that this strain was resistant to Ertapenem, but the zone diameter was 21 mm for scaffold and 20 mm for cement. Ertapenem-loaded scaffold was found to be more effective than cement. When we evaluated the release profiles, for the Daptomycin-loaded cement group, 98%of Daptomycin was cumulatively released within 30 min, and for the Daptomycin-loaded scaffold group, 100%of Daptomycin was cumulatively released in 6 days. To compare Ertapenem- loaded cement and scaffold, 98% of Ertapenem was cumulatively released within 10 min in the cement group. For the scaffold group, 100% of Ertapenem was cumulatively released in 17 days. It was found that e scaffold released the antibiotic more slowly and for a longer duration.