Low-cost antibiotic delivery system for the treatment of osteomyelitis in developing countries

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Although application of biomaterials has been one of the major assets in modern medicine to improve the quality of life of patients, occurrence of a chronic osteomyelitis is still a serious health threat to the individual patient. Chronic osteomyelitis can result in morbidity affecting the viability of an affected limb. Biofilm formation on avascular bone protects pathogens and leads to the persistence of infection. fosfomycin-loaded polymethylmethacrylate (PMMA) beads are handmade by orthopedic surgeon in Indonesia to treat the disease. Up to now, the efficaciousness of these beads as compared to the commercially available ones (such as Septopale) has never been studied, therefore, the clinical result is still in doubt, whether it comes from the systemic antibiotics, the beads itself or surgical intervention. To have better antibiotic release from the bone cement beads some requirements should be considered such as uniform size in diameter, spherical shape, porosity, and antibiotic concentration.

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