Inhibitive Effect of Antibiotic-Loaded Beads to Cure Chronic Osteomyelitis in Developing Country: Hand-made vs Commercial Beads

Local antibiotic-loaded beads have been approved for standard treatment of orthopaedic pathogens, especially chronic osteomyelitis. Septopal®, the only commercial local antibiotic bead available on the market, is expensive and contains only gentamicin. This study aimed to compare the

in vitro

inhibitive effect of hand-made antibioticloaded beads (fosfomycin-sodium) with Septopal® for ten bacterial strains of chronic osteomyelitis by diffussion technique at various indicated time points. The results showed that Septopal® could inhibit all bacterial strains except CNS 7334 and CNS 7391. Hand-made fosfomycin beads were only slightly effective in two of the ten bacterial strains is used (

Staphylococcus aureus

7323 and CNS 7391). In conclusion, this study demonstrated that Septopal® can inhibit common orthopaedic pathogens better than hand-made beads

in vitro

study, however, fosfomycin concentrations required to kill orthopedic implant related bacterial strains are high and its release from hand-made beads is too low to be considered efective when compared with Septopal beads.