Local Intramedullary Delivery of Vancomycin Can Prevent the Development of Long Bone Staphylococcus aureus Infection

PLoS One. 2016 Jul 29;11(7):e0160187. doi: 10.1371/journal.pone.0160187. eCollection 2016.

Abstract

Current treatments for methicillin-resistant Staphylococcus aureus (MRSA) infections require intravenously delivered vancomycin; however, systemically delivered vancomycin has its problems. To determine the feasibility and safety of locally delivering vancomycin hydrochloride (~25 mg/Kg) to the medullary canal of long bones, we conducted a pharmacokinetics study using a rat tibia model. We found that administering the vancomycin intraosseously resulted in very low concentrations of vancomycin in the blood plasma and the muscle surrounding the tibia, reducing the risk for systemic toxicity, which is often seen with traditional intravenous administration of vancomycin. Additionally, we were able to inhibit the development of osteomyelitis in the tibia if the treatment was administered locally at the same time as a bacterial inoculum (i.e., Log10 7.82 CFU/mL or 6.62x107 CFU/mL), when compared to an untreated group. These findings suggest that local intramedullary vancomycin delivery can achieve sufficiently high local concentrations to prevent development of osteomyelitis while minimizing systemic toxicity.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacokinetics
  • Bone and Bones*
  • Chromatography, High Pressure Liquid
  • Drug Administration Routes*
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / microbiology
  • Rats
  • Rats, Sprague-Dawley
  • Vancomycin / administration & dosage*
  • Vancomycin / pharmacokinetics

Substances

  • Anti-Bacterial Agents
  • Vancomycin

Grants and funding

This work was supported by the University of Utah Research Foundation to JA. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.