Gentamicin-loaded poly(lactic-co-glycolic acid) microparticles for the prevention of maxillofacial and orthopedic implant infections

From Polymeric Nanoformulations to Polyphenols-Strategies for Enhancing the Efficacy and Drug Delivery of Gentamicin

Gentamicin is an essential broad-spectrum aminoglycoside antibiotic that is used in over 40 clinical conditions and has shown activity against a wide range of nosocomial, biofilm-forming, multi-drug resistant bacteria. Nevertheless, the low cellular penetration and serious side effects of gentamicin, as well as the fear of the development of antibacterial resistance, has led to a search for ways to circumvent these obstacles. This review provides an overview of the chemical and pharmacological properties of gentamicin and offers six different strategies (the isolation of specific types of gentamicin, encapsulation in polymeric nanoparticles, hydrophobization of the gentamicin molecule, and combinations of gentamicin with other antibiotics, polyphenols, and natural products) that aim to enhance the drug delivery and antibacterial activity of gentamicin. In addition, factors influencing the synthesis of gentamicin-loaded polymeric (poly (lactic-co-glycolic acid) (PLGA) and chitosan) nanoparticles and the methods used in drug release studies are discussed. Potential research directions and future perspectives for gentamicin-loaded drug delivery systems are given.

Review on PLGA Polymer Based Nanoparticles with Antimicrobial Properties and Their Application in Various Medical Conditions or Infections

The rise in the resistance to antibiotics is due to their inappropriate use and the use of a broad spectrum of antibiotics. This has also contributed to the development of multidrug-resistant microorganisms, and due to the unavailability of suitable new drugs for treatments, it is difficult to control. Hence, there is a need for the development of new novel, target-specific antimicrobials. Nanotechnology, involving the synthesis of nanoparticles, may be one of the best options, as it can be manipulated by using physicochemical properties to develop intelligent NPs with desired properties. NPs, because of their unique properties, can deliver drugs to specific targets and release them in a sustained fashion. The chance of developing resistance is very low. Polymeric nanoparticles are solid colloids synthesized using either natural or synthetic polymers. These polymers are used as carriers of drugs to deliver them to the targets. NPs, synthesized using poly-lactic acid (PLA) or the copolymer of lactic and glycolic acid (PLGA), are used in the delivery of controlled drug release, as they are biodegradable, biocompatible and have been approved by the USFDA. In this article, we will be reviewing the synthesis of PLGA-based nanoparticles encapsulated or loaded with antibiotics, natural products, or metal ions and their antibacterial potential in various medical applications.

Insight in Superiority of the Hydrophobized Gentamycin in Terms of Antibiotics Delivery to Bone Tissue

Bone infections are a serious problem to cure, as systemic administration of antibiotics is not very effective due to poor bone vascularization. Therefore, many drug delivery systems are investigated to solve this problem. One of the potential solutions is the delivery of antibiotics from poly(L-actide-co-glycolide) (PLGA) nanoparticles suspended in the gellan gum injectable hydrogel. However, the loading capacity and release kinetics of the system based on hydrophilic drugs (e.g., gentamycin) and hydrophobic polymers (e.g., PLGA) may not always be satisfying. To solve this problem, we decided to use hydrophobized gentamycin obtained by ion-pairing with dioctyl sulfosuccinate sodium salt (AOT). Herein, we present a comparison of the PLGA nanoparticles loaded with hydrophobic or hydrophilic gentamycin and suspended in the hydrogel in terms of physicochemical properties, drug loading capacity, release profiles, cytocompatibility, and antibacterial properties. The results showed that hydrophobic gentamycin may be combined in different formulations with the hydrophilic one and is superior in terms of encapsulation efficiency, drug loading, release, and antibacterial efficacy with no negative effect on the NPs morphology or hydrogel features. However, the cytocompatibility of hydrophobic gentamycin might be lower, consequently more extensive study on its biological properties should be provided to evaluate a safe dose.

Megaprosthesis anti-bacterial coatings: A comprehensive translational review

Periprosthetic joint infections (PJI) are catastrophic complications for patients with implanted megaprostheses and pose significant challenges in the management of orthopaedic oncology patients. Despite various preventative strategies, with the increasing rate of implanted orthopaedic prostheses, the number of PJIs may be increasing. PJIs are associated with a high rate of amputation. Therefore, novel strategies to combat bacterial colonization and biofilm formation are required. A promising strategy is the utilization of anti-bacterial coatings on megaprosthetic implants. In this translational review, a brief overview of the mechanism of bacterial colonization of implants and biofilm formation will be provided, followed by a discussion and classification of major anti-bacterial coatings currently in use and development. In addition, current in vitro outcomes, clinical significance, economic importance, evolutionary perspectives, and future directions of anti-bacterial coatings will also be discussed. Megaprosthetic anti-bacterial coating strategies will help reduce infection rates following the implantation of megaprostheses and would positively impact sarcoma care. STATEMENT OF SIGNIFICANCE: This review highlights the clinical challenges and a multitude of potential solutions to combating peri-prosthetic join infections in megaprotheses using anti-bacterial coatings. Reducing infection rates following the implantation of megaprostheses would have a major impact on sarcoma care and major trauma surgeries that require reconstruction of large skeletal defects.

Polydopamine treatment of chitosan nanofibers for the conception of osteoinductive scaffolds for bone reconstruction

We report the influence of treatment time of electrospun chitosan nanofibers (CHT NFs) in dopamine hydrochloride bath (2 mg.mL^-1 in 10 mM Tris buffer, pH 8.5) on the extent of the polydopamine (pDA) coating on NFs surface. The reaction was characterized by FTIR and SEM analysis and the cytocompatibility of the scaffolds toward MT3C3-E1 cells was assessed. Biomimetic deposition of hydroxyapatite (HA) in 1.5xSBF batch was investigated by SEM-EDS and XRD. Samples treated in dopamine bath during 2 h promoted the structural stability of NFs in PBS, provided optimal cytocompatibility and induced the in vitro biomineralization from 6 days in 1.5xSBF. The XRD and SEM-EDS investigations confirmed formation of spherical-shaped particles composed of apatitic phase. Finally, this study shows that these NFs-pDA scaffolds prepared in the optimal experimental conditions defined here are promising candidates for application as osteoinductive scaffolds for bone regeneration applied to orthopedic and dental applications.

Polymeric nano- and microparticulate drug delivery systems for treatment of biofilms

Now-a-days healthcare systems face great challenges with antibiotic resistance and low efficacy of antibiotics when combating pathogenic bacteria and bacterial biofilms. Administration of an antibiotic in its free form is often ineffective due to lack of selectivity to the infectious site and breakdown of the antibiotic before it exerts its effect. Therefore, polymeric delivery systems, where the antibiotic is encapsulated into a formulation, have shown great promise, facilitating a high local drug concentration at the site of infection, a controlled drug release and less drug degradation. All this leads to improved therapeutic effects and fewer systemic side effects together with a lower risk of developing antibiotic resistance. Here, we review and provide a comprehensive overview of polymer-based nano- and microparticles as carriers for antimicrobial agents and their effect on eradicating bacterial biofilms. We have a main focus on polymeric particulates containing poly(lactic-co-glycolic acid), chitosan and polycaprolactone, but also strategies involving combinations of these polymers are included. Different production techniques are reviewed and important parameters for biofilm treatment are discussed such as drug loading capacity, control of drug release, influence of particle size and mobility in biofilms. Additionally, we reflect on other promising future strategies for combating biofilms such as lipid-polymer hybrid particles, enzymatic biofilm degradation, targeted/triggered antibiotic delivery and future alternatives to the conventional particles.

[Research progress on antibacterial properties of porous medical implant materials]

OBJECTIVE

The antibacterial properties of porous medical implant materials were reviewed to provide guidance for further improvement of new medical implant materials.

METHODS

The literature related to the antibacterial properties of porous medical implant materials in recent years was consulted, and the classification, characteristics and applications, and antibacterial methods of porous medical implant materials were reviewed.

RESULTS

Porous medical implant materials can be classified according to surface pore size, preparation process, degree of degradation in vivo, and material source. It is widely used in the medical field due to its good biocompatibility and biomechanical properties. Nevertheless, the antibacterial properties of porous medical implant materials themselves are not obvious, and their antibacterial properties need to be improved through structural modification, overall modification, and coating modification.

CONCLUSION

At present, coating modification as the mainstream modification method for improving the antibacterial properties of porous medical materials is still a research hotspot. The introduction of new antibacterial substances provides a new perspective for the development of new coated porous medical implant materials, so that the porous medical implant materials have a more reliable antibacterial effect while taking into account biocompatibility.

Derivatization-free determination of aminoglycosides by CZE-UV in pharmaceutical formulations

Aminoglycosides are a relevant class of antibiotics widely used by medics and veterinaries. There are a variety of reasons that make their determination relevant, such as quality control, environment and food contamination assessment, drug-release studies, among others. The lack of a chromophore makes aminoglycoside spectrophotometric detection particularly challenging, often requiring derivatization. In this work, an indirect detection method, making use of imidazole as a probe, applying CZE was successfully tested. It did not require derivatization, which simplified the sample preparation. Suitable figures of merit were obtained; recoveries between 95 and 105%, adequate repeatability and precision, correlation coefficients (r) above 0.998, and limits of detection (LODs) of 3.2 and 11 mg/L for gentamicin and paromomycin, respectively. As a proof-of-concept, it was also applied in a simple controlled release experiment that was well fitted using the Hill equation.

Assessing the Bioactivity of Gentamicin-Preloaded Hydroxyapatite/Chitosan Composite Coating on Titanium Substrate

The electrophoretic deposition process (EPD) was utilized to produce bioactive hydroxyapatite/chitosan (HAP/CS) and hydroxyapatite/chitosan/gentamicin (HAP/CS/Gent) coatings on titanium. The bioactivity of newly synthesized composite coatings was investigated in the simulated body fluid (SBF) and examined by X-ray diffraction, Fourier transform infrared spectroscopy, and field emission scanning electron microscopy. The obtained results revealed carbonate-substituted hydroxyapatite after immersion in SBF, emphasizing the similarity of the biomimetically grown HAP with the naturally occurring apatite in the bone. The formation of biomimetic HAP was confirmed by electrochemical impedance spectroscopy and polarization measurements, through the decrease in corrosion current density and coating capacitance values after 28-day immersion in SBF. The osseointegration ability was further validated by measuring the alkaline phosphatase activity (ALP) indicating the favorable osseopromotive properties of deposited coatings (significant increase in ALP levels for both HAP/CS (3.206 U mL-1) and HAP/CS/Gent (4.039 U mL-1) coatings, compared to the control (0.900 U mL-1)). Drug-release kinetics was investigated in deionized water at 37 °C by high-performance liquid chromatography coupled with mass spectrometry. Release profiles revealed the beneficial "burst-release effect" (∼21% of gentamicin released in the first 48 h) as a potentially promising solution against the biofilm formation in the initial period. When tested against human and mice fibroblast cells (MRC-5 and L929), both composite coatings showed a noncytotoxic effect (viability >85%), providing a promising basis for further medical application trials.

Synergistic treatment strategies to combat resistant bacterial infections using Schiff base modified nanoparticulate - hydrogel system

Antibiotic resistance is of much prevalence and is one of the alarming realities for the rise in morbidity and mortality. Antibiotics; once regarded as wonder drugs have lost its credit of combating bacteria due to the rapid rise in variety of nosocomial pathogens. The underlying cause for the resistance spread is due to sudden drift in genetic mutation and the recalcitrant behavior of bacterial species. On the other hand, illegal and overconsumption of drugs fuels up the issue, wherein resistance development is directly proportional to the rate of drug consumption. Our pursuit was in reviving antibiotic, and further repurposing them into more potent formulation with reduced side effects to completely deplete resistant bacteria. In this work we present gentamicin encapsulated zein nanoparticle modified with Schiff base incorporated in immobilized chitosan-polyvinyl alcohol gel matrix([GM-ZNP]PG CsPVA) resulting in synergistic antibacterial activity. Schiff base modified zein nanoparticle exhibited an average diameter of 240 ± 8 nm and stability of -29.85 ± 2 mV. The nanocomposite system exhibited enhanced penetration rate when applied to dermis eliciting combinatorial antibacterial activity. Gentamicin in combination with Schiff base was found to lyse bacteria by ruining its cell integrity as depicted by SEM analysis. The formulation upon application stays intact to the impaired dermal tissues and releases drug in a sustained manner without the need of recurrent administration. The gel system was extremely biocompatible towards L929 cells without any toxicity. Overall, the work reports use of [GM-ZNP]PG CsPVA for resistant bacterial infections.

Plasma-Deposited Nanocapsules Containing Coatings for Drug Delivery Applications

Coatings consisting in gentamicin-containing nanocapsules have been synthetized by means of an aerosol-assisted atmospheric pressure plasma deposition process. The influence of different parameters affecting the process has been extensively investigated by means of a morphological and chemical characterization of the coatings. Scanning electron microscopy highlighted the presence of nanocapsules whose size and abundance depend on power input and deposition time. A detailed analysis carried out with matrix-assisted laser desorption ionization coupled to high-resolution mass spectrometry allowed to detect and identify the presence of gentamicin embedded in the coatings and its rearrangement, as a result of the interaction with the plasma. The release of gentamicin in water has been monitored by means of UV-vis fluorescence spectroscopy, and its biological activity has been evaluated as well by the disk diffusion assay against Staphylococcus aureus and Pseudomonas aeruginosa. It is confirmed that the antibacterial activity of gentamicin is preserved in the plasma-deposited coatings. Preliminary cytocompatibility investigations indicated that eukaryotic cells well tolerate the release of gentamicin from the coatings.

Design and evaluation of antibiotic releasing self- assembled scaffolds at room temperature using biodegradable polymer particles

Biodegradable polymer-based drug-eluting implants offer many advantages such as predictable drug release kinetics, safety, and acceptable drug loading under ambient conditions. Herein, we describe fabrication and evaluation of antibiotic loaded scaffolds for localized delivery and tissue engineering applications. PDLLA particles entrapping gentamycin were formulated using solvent evaporation method and used for scaffold fabrication. Optimization of formulation parameters such as pH of the internal aqueous phase and combination of excipients like glycerol, polyvinyl alcohol (PVA) resulted in high entrapment efficiencies up to 96% of gentamicin in particles with drug load of 16-18μg/mg of polymer particles. These microparticles were fused in presence of methanol at ambient temperatures to form scaffolds of different geometry having reasonable mechanical strength. Porosity of these scaffolds was found to be more than 80%. Antibiotic released from the scaffolds was found to be bioactive as tested against Staphylococcus aureus and the release pattern was biphasic over a period of one week. The scaffolds were found to be non-toxic to murine fibroblasts cultures in vitro as well as to mice upon subcutaneous implantation. This method provides a novel and easy way of fabricating antibiotic loaded polymer scaffolds for varieties of applications.