Triple Encapsulation and Controlled Release of Vancomycin, Rifampicin and Silver from Poly (Methyl Methacrylate) or Poly (Lactic-Co-Glycolic Acid) Nanofibers

TL;DR

This paper presents a new method to encapsulate and release three antibiotics in nanofiber mats to prevent or treat orthopedic implant infections.

Contribution

A novel triple-drug encapsulation and controlled release system using PMMA or PLGA nanofibers is developed for orthopedic infection prevention.

Findings

Vancomycin, rifampicin, and silver sulfadiazine were effectively encapsulated in PMMA or PLGA nanofibers.

The addition of PEG improved drug release and wetting properties of the nanofiber mats.

The drug combination showed synergistic or additive effects against a broad range of bacteria.

Abstract

Although the incidence of infections in orthopedic surgeries, including periprosthetic surgeries, remains low at approximately 1–2%, the number of surgeries and the incidence of drug-resistant bacteria is increasing. The cost and morbidity associated with revision surgeries are huge. More effective drug combinations and delivery methods are urgently needed. In this paper, three anti-infective drugs (vancomycin, rifampicin, and silver sulfadiazine) have been jointly and effectively electrospun in thin (0.1 mm) flexible nanofiber mats of either poly (methyl methacrylate) (PMMA) or poly (lactic-co-glycolic acid) (PLGA). The inclusion of poly (ethylene glycol) (PEG) enabled optimal drug release with a reduced water contact angle for wetting. The controlled release of these three agents from 20% PEG (w/w to polymer)-blended PMMA or PLGA nanofiber mats may allow for the prophylactical prevention of implant-related infections or provide methods to treat orthopedic infections at the time of revision surgeries. These combinations of drugs provide excellent additive or synergistic antibiotic action against a broader spectrum of bacteria than each drug alone.

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