Microwaves increase the effectiveness of systemic antibiotic treatment in acute bone infection: experimental study in a
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(2019) 14:286
RESEARCH ARTICLE
Open Access
Microwaves increase the effectiveness of systemic antibiotic treatment in acute bone infection: experimental study in a rat model Xiao-yang Qi1,3, Xu-sheng Qiu1,2*, Jiang-yun Jiang1, Yi-xin Chen1,2* , Li-ming Tang3 and Hong-fei Shi1,2
Abstract Background: Osteomyelitis is a challenge for orthopedic surgeons due to its protracted treatment process. Microwaves (MWs) can increase blood perfusion due to their thermal effect. Furthermore, MWs demonstrated significant bactericidal effects in vitro. In the present study, we assumed that the application of a 2450-MHz-frequency MW together with systemic antibiotic treatment would provide synergy for the treatment of acute osteomyelitis. Methods: The medullary cavity of the right tibia was inoculated with 107 CFU of methicillin-sensitive Staphylococcus aureus (MSSA-ATCC 29213) in 40 rats, and the rats were randomly divided into four groups according to treatment: group I, saline (control); group II, saline + MW therapy; group III, systemic cefuroxime; and group IV, systemic cefuroxime + MW therapy. MWs were applied for 20 min per day to the infected limbs, and all rats were sacrificed on the 7th day. The severity of tibial osteomyelitis was assessed by quantitative culture analysis. Results: Bacterial counts in groups III and IV were significantly reduced compared with those in the control (p = 0.001 and < 0.001, respectively). Furthermore, significant differences were detected between groups III and IV (p = 0.033). However, the difference between groups I and II was nonsignificant (p = 0.287). Conclusion: Our experimental model suggests that MW therapy provides a significant synergy for systemic antibiotic treatment. However, further clinical trials are required to safely use this treatment modality in patients. Keywords: Microwave, Osteomyelitis, Staphylococcus aureus, Cefuroxime
Introduction Osteomyelitis is an inflammatory disorder of the bone caused by infection [1]. It is still challenging for orthopaedic surgeons because of its protracted treatment process. The reported infection control rate ranges from 67 to 95% [2], which means that 5% to 33% of patients suffer from recurrence of infection. In recent years, some new adjuvant treatments have been attempted to treat and cure osteomyelitis, for example, hyperbaric oxygen therapy, pulsed electromagnetic fields, ultrasound, laser, and extracorporeal shockwave, which have been demonstrated with successful results in the treatment of osteomyelitis [3–6]. Despite advances in surgical treatment, antibiotic therapy, diagnostic methods, and
* Correspondence: [email protected]; [email protected] 1 Department of Orthopaedics, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, China Full list of author information is available at the end of the article
differentiated approaches to each type of osteomyelitis, the treatment outcomes are still unsatisfactory [7]. As we know, the local blood supply to the bone is impaired in
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