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 (R), 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 antibiotic-loaded beads (fosfomycin-sodium) with Septopal (R) for ten bacteria[ strains of chronic osteomyelitis by diffussion technique at various indicated time points. The results showed that Septopal (R) 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 (R) 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.</p