# 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.

## Key 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.