Jacob E, Setterstrom J A, Bach D E, Heath J R, McNiesh L M, Cierny G
United States Army Institute of Dental Research, Walter Reed Army Medical Center, Washington, DC 20307-5300.
Clin Orthop Relat Res. 1991 Jun(267):237-44.
Successful treatment of chronic osteomyelitis requires sustained high concentrations of antibiotics locally within the infected bone. The efficacy of biodegradable (poly-DL-lactide-co-glycolide) microspheres containing 30.7% ampicillin anhydrate for the local treatment of experimental staphylococcal osteomyelitis was evaluated in rabbits. In the initial experiment, antibiotic therapy was initiated immediately following injection of Staphylococcus aureus into the proximal tibial metaphysis. A single intramedullary injection of microencapsulated ampicillin (100 mg) prevented osteomyelitis in all seven animals tested and was as effective as a two-week course of parenteral ampicillin administration. When antibiotic therapy was delayed for seven days, osteomyelitis developed in four of eight animals treated locally with microencapsulated ampicillin and in six of eight animals that received parenteral ampicillin therapy. When antibiotic therapy was delayed for seven days and was preceded by debridement, all ten animals treated locally with microencapsulated ampicillin had sterile bone cultures. In contrast, seven of ten animals treated locally with unencapsulated ampicillin powder developed osteomyelitis. Biodegradable antibiotic-loaded microspheres may be of clinical benefit for the local treatment of chronic osteomyelitis.
成功治疗慢性骨髓炎需要在感染骨局部持续维持高浓度的抗生素。对含30.7%无水氨苄西林的可生物降解（聚-DL-丙交酯-共-乙交酯）微球用于兔实验性葡萄球菌骨髓炎局部治疗的疗效进行了评估。在初始实验中，将金黄色葡萄球菌注入胫骨近端干骺端后立即开始抗生素治疗。单次髓内注射微囊化氨苄西林（100毫克）可预防所有7只受试动物发生骨髓炎，其效果与为期两周的胃肠外氨苄西林给药疗程相同。当抗生素治疗延迟7天时，8只局部接受微囊化氨苄西林治疗的动物中有4只发生骨髓炎，8只接受胃肠外氨苄西林治疗的动物中有6只发生骨髓炎。当抗生素治疗延迟7天且在清创后进行时，所有10只局部接受微囊化氨苄西林治疗的动物骨培养均无菌。相比之下，10只局部用未包囊的氨苄西林粉末治疗的动物中有7只发生骨髓炎。载有抗生素的可生物降解微球可能对慢性骨髓炎的局部治疗具有临床益处。
