Chronic
osteomyelitis is mostly caused by bacteria such as S. aureus, and is often treated with oral
antibiotics or
injections to suppress the bacteria. In severe cases, however, surgical treatment using
antibiotic beads and
metal supports may be required. In these surgeries, bacterial attachment to the
metal may lead to biofilm formation and reduce
antibiotics' penetration to the bacteria. Reoperation must be performed to prevent bacterial inflammatory reactions and antibiotic resistance. Thus, in this study, we developed a dual-drug-releasing PCL/
sodium-alginate-based 3D-printed scaffold to effectively treat
osteomyelitis by removing the biofilm. We proposed an
antibiotic-loaded biodegradable
polymer scaffold using 3D printing, which was encapsulated by a second
antibiotic-containing
hydrogel. Then, we successfully established a dual-drug-based scaffold that consisted of a
cefazolin (CFZ)-containing
polycaprolactone 3D scaffold and a
rifampicin (RFP)-loaded
alginate hydrogel encapsulating the 3D scaffold. Our scaffold showed a synergistic effect, whereby biofilm formation was inhibited by RFP, which is an external drug, and bacterial activity was inhibited by CFZ, which is an internal drug that increases antibacterial activity. We also confirmed that the dual-drug-based scaffold did not affect the proliferation of human osteoblasts. Our findings suggest that this dual drug delivery system may serve as a new therapeutic treatment for
osteomyelitis that overcomes the limitations of individual drugs.