Composite materials composed of
borate bioactive glass and
chitosan (designated BGC) were investigated in vitro and in vivo as a new delivery system for
teicoplanin in the treatment of chronic
osteomyelitis induced by methicillin-resistant Staphylococcus aureus (MRSA). In vitro, the release of
teicoplanin from BGC pellets into
phosphate-buffered saline (PBS), as well as its antibacterial activity, were determined. The compressive strength of the pellets was measured after specific immersion times, and the structure of the pellets was characterized using scanning electron microscopy and X-ray diffraction. In vivo, the tibial cavity of New Zealand White rabbits was injected with MRSA strain to induce chronic
osteomyelitis, treated by
debridement after 4weeks, implanted with
teicoplanin-loaded BGC pellets (designated TBGC) or BGC pellets, or injected intravenously with
teicoplanin. After 12weeks' implantation, the efficacy of the TBGC pellets for treating
osteomyelitis was evaluated using hematological, radiological, microbiological and histological techniques. When immersed in PBS, the TBGC pellets provided a sustained release of
teicoplanin, while the surface of the pellets was converted to
hydroxyapatite (HA). In vivo, the best
therapeutic effect was observed in animals implanted with TBGC pellets, resulting in significantly lower radiological and histological scores, a lower positive rate of MRSA culture, and an excellent bone defect repair, without local or systemic side effects. The results indicate that TBGC pellets are effective in treating chronic
osteomyelitis by providing a sustained release of
teicoplanin, in addition to participating in bone regeneration.