New antibiotic-based cement helps treat bone infections

October 19, 2022
New antibiotic-based cement helps treat bone infection

Researchers from Brigham and Women’s Hospital (BWH) have developed a novel bone cement matrix loaded with antibiotics to treat bone infections common in post-surgical orthopaedic procedures, such as knee replacement surgery.

A bone cement, in powder or liquid form, is used to affix protheses or artificial joints tightly to the bone.

Sadly, patients with antibiotic bone cements are becoming increasingly resistant to the antibiotics and also sustain damage to beneficial microbiota, which might help them beat bacterial infection, for example. In addition, given the increasing aging population who most likely require orthopaedic procedures, it is now more necessary than ever to have effective antibiotic for targeted use in a bone cement matrix.

Collaborating researchers from the BWH’s Department of Medicine and the Department of Orthopaedic Surgery thus aimed to engineer a new antibiotic for specific local delivery via a bone cement matrix.

Using polymethylmethacrylate (PMMA) bone cement, the researchers shortlisted molecules for antibiotic design and screened for drug-susceptible and drug-resistant bacteria in a preclinical model – all in all, the researchers managed to construct a computer-program-generated library of antibiotics, which pointed them to dual-action antibiotic VCD-077.

VCD-077 not only exhibited desired drug release kinetics without affecting the stability of PMMA bone cement, but it also demonstrated high efficacy against a broad range of drug-resistant bacteria strands and slowed development of future resistance.

In experiments, VCD-077-loaded PMMA bone cement exhibited greater efficacy than all currently used antibiotic-loaded bone cements against bacterial bone infections in a rat model.

The researchers are banking on a future tissue-specific, localised treatment, such as a minimally-invasive injection of antibiotic-infused bone cement, that does its job without perpetuating drug resistance. Their work on the computer program also signals potential application for computer programming and AI technology to streamline drug development.

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