Fiore Michele, Bruschi Alessandro, Giannini Claudio, Morante Lorenzo, Rondinella Claudia, Filippini Matteo, Sambri Andrea, De Paolis Massimiliano
Orthopaedic and Traumatology Unit, IRRCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy.
Antibiotics (Basel). 2022 Jul 24;11(8):995. doi: 10.3390/antibiotics11080995.
Antibiotic-laden bone substitutes represent a viable option in the treatment of bone and joint infections with bone defects. In particular, the addition of silver ions or silver nanoparticles to bone substitutes to achieve local antiseptic activity could represent a further contribution, also helping to prevent bacterial resistance to antibiotics. An in-depth search of the main scientific databases was performed regarding the use of silver compounds for bone substitution. The available evidence is still limited to the preclinical level: 22 laboratory studies, 2 animal models, and 3 studies, with both in vitro and in vivo analysis, were found on the topic. Numerous biomaterials have been evaluated. In vitro studies confirmed that silver in bone substitutes retains the antibacterial activity already demonstrated in coatings materials. Cytotoxicity was generally found to be low and only related to silver concentrations higher than those sufficient to achieve antibacterial activity. Instead, there are only a few in vivo studies, which appear to confirm antibacterial efficacy, although there is insufficient evidence on the pharmacokinetics and safety profile of the compounds investigated. In conclusion, research on bone substitutes doped with silver is in its early stages, but the preliminary findings seem promising.
载抗生素骨替代物是治疗伴有骨缺损的骨与关节感染的一种可行选择。特别是，在骨替代物中添加银离子或银纳米颗粒以实现局部抗菌活性可能会有进一步作用，也有助于防止细菌对抗生素产生耐药性。针对使用银化合物进行骨替代的情况，对主要科学数据库进行了深入检索。现有证据仍局限于临床前水平：关于该主题，发现了22项实验室研究、2个动物模型以及3项兼具体外和体内分析的研究。已对众多生物材料进行了评估。体外研究证实，骨替代物中的银保留了涂层材料中已证实的抗菌活性。一般发现细胞毒性较低，且仅与高于实现抗菌活性所需浓度的银浓度有关。相反，体内研究较少，尽管关于所研究化合物的药代动力学和安全性方面证据不足，但这些研究似乎证实了抗菌效果。总之，掺杂银的骨替代物研究尚处于早期阶段，但初步研究结果似乎很有前景。
