Prevention and treatment of experimental osteomyelitis in dogs with ciprofloxacin‐loaded crosslinked high amylose starch implants

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Abstract
Crosslinked high amylose starch (CLHAS) matrix was used as a biodegradable drug delivery implant for the prevention and treatment of osteomyelitis. Thirty‐two dogs underwent the femoral insertion of a screw inoculated withStaphylococcus aureusand were then randomly assigned to four groups: (A) prevention with ciprofloxacin‐CLHAS implants, (B) surgical debridement (positive control), (C) surgical debridement and oral ciprofloxacin treatment and (D) surgical debridement and treatment with ciprofloxacin‐CLHAS implants. At week 4 the osteomyelitis was confirmed, the infected site debrided and respective treatments initiated for groups B, C and D. Radiographs, macroscopic evaluations, bacterial cultures and histopathological examinations were used to evaluate the femora at week 10. Femora from preventive group A were almost normal. Dogs of both ciprofloxacin treatment groups C and D showed better bone healing, less periosteal reaction and less screw mobility than dogs from group B. Eradication of infection was observed at proximal/distal sites in B: 25%/12%, C: 37%/62% and D: 62%/75%. Both ciprofloxacin treated groups improved radiographically from week 4 to week 10. Periosteal and marrow neutrophilic and lymphoplasmocytic infiltrations were less severe in groups C and D versus group B. These data suggest that biodegradable ciprofloxacin‐CLHAS implants are a safe and efficient modality for the prevention and treatment of osteomyelitis. © 2004 Orthopaedic Research Society. Published y Elsevier Ltd. All rights reserved.

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