Drug Delivery Systems in Osteomyelitis Treatment

Osteomyelitis poses a persistent challenge to clinicians owing to deep-seated microbial colonisation, biofilm formation and antibiotic resistance within bone tissue. Traditional systemic antibiotic regimens frequently fail to achieve bactericidal concentrations at the infection site and carry risks of systemic toxicity. Localised delivery platforms—ranging from biodegradable scaffolds and hydrogels to advanced nanocarriers and three-dimensional-printed implants—have emerged to combine sustained antimicrobial release with support for bone regeneration. These systems aim to overcome microbial defence mechanisms, deliver high local drug doses, reduce systemic side-effects and promote osteogenesis. Key strategies include the incorporation of antibiotics or enzymes into biocompatible matrices, tuning of porosity and degradation rates, and the use of stimulus-responsive materials to achieve on-demand release in infected or inflamed microenvironments.

Research from Nature Portfolio

Recent efforts have centred on the fabrication of implantable architectures that integrate both antimicrobial and osteoinductive functions. One study introduced a rifampicin-loaded polycaprolactone scaffold, produced via low-temperature 3D printing to preserve antibiotic potency. The construct exhibited interconnected porosity, sustained rifampicin release, potent inhibition of Staphylococcus aureus and Escherichia coli, and cytocompatibility with human osteoblasts, illustrating its potential for patient-customised therapy. A complementary approach employed levofloxacin-loaded mesoporous silica microspheres embedded in a nano-hydroxyapatite/polyurethane matrix. In a rabbit model of chronic osteomyelitis, this composite scaffold outperformed non-degradable polymethyl methacrylate beads by promoting bone defect repair while eradicating infection over a 12-week period. These platforms exemplify the dual requirement for antimicrobial efficacy and osteoconductive support in next-generation osteomyelitis treatment.

Drug Delivery Systems in Osteomyelitis Treatment publication trend

The graph below shows the total number of articles in drug delivery systems in osteomyelitis treatment across all publications each year (not limited to Nature Index journals).

Technical terms

Scaffold: A three-dimensional structure designed to support cell attachment, guide tissue growth and serve as a matrix for drug loading and release.

Hydrogel: A crosslinked, water-retentive polymer network capable of encapsulating therapeutic agents and providing controlled release through swelling or degradation.

Biofilm: A structured community of microorganisms adherent to a surface and encased in an extracellular matrix, exhibiting increased resistance to antibiotics.

Mesoporous silica: A silica material containing uniform nanoscale pores that enable high-capacity drug loading and tunable release kinetics.

Osteoconductivity: The capacity of a material to support the attachment and growth of new bone along its surface without inducing bone formation de novo.

References

1. Prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections. Bone Research (2024).
2. Levofloxacin loaded mesoporous silica microspheres/nano-hydroxyapatite/polyurethane composite scaffold for the treatment of chronic osteomyelitis with bone defects. Scientific Reports (2017).
3. Development of a heat labile antibiotic eluting 3D printed scaffold for the treatment of osteomyelitis. Scientific Reports (2020).
4. Calcium Phosphate Spacers for the Local Delivery of Sitafloxacin and Rifampin to Treat Orthopedic Infections: Efficacy and Proof of Concept in a Mouse Model of Single-Stage Revision of Device-Associated Osteomyelitis. Pharmaceutics (2019).
5. Transglutaminase Cross-Linked Gelatin-Alginate-Antibacterial Hydrogel as the Drug Delivery-Coatings for Implant-Related Infections. Polymers (2021).