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The in vitro and in vivo studies presented herein evaluated the antimicrobial effects of applying cathodic voltage\u2010controlled electrical stimulation (CVCES) to titanium implants inoculated with preformed bacterial biofilms of methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA). The in vitro studies showed that combining vancomycin therapy (500\u2009\u00b5g\/mL) with application of CVCES at \u22121.75\u2009V (all voltages are with respect to Ag\/AgCl unless otherwise stated) for 24\u2009h resulted in 99.98% reduction in the coupon\u2010associated MRSA colony\u2010forming units (CFUs) (3.38\u2009\u00d7\u200910<jats:sup>3<\/jats:sup> vs. 2.14\u2009\u00d7\u200910<jats:sup>7<\/jats:sup>CFU\/mL, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and a 99.97% reduction in the planktonic CFU (4.04\u2009\u00d7\u200910<jats:sup>4<\/jats:sup> vs. 1.26\u2009\u00d7\u200910<jats:sup>8<\/jats:sup>CFU\/mL, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) as compared with the no treatment control samples. The in vivo studies utilized a rodent model of MRSA IAIs and showed a combination of vancomycin therapy (150\u2009mg\/kg twice daily) with CVCES of \u22121.75\u2009V for 24\u2009h had significant reductions in the implant associated CFU (1.42\u2009\u00d7\u200910<jats:sup>1<\/jats:sup> vs. 1.2\u2009\u00d7\u200910<jats:sup>6<\/jats:sup> CFU\/mL, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.003) and bone CFU (5.29\u2009\u00d7\u200910<jats:sup>1<\/jats:sup> vs. 4.48\u2009\u00d7\u200910<jats:sup>6<\/jats:sup> CFU\/mL, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.003) as compared with the untreated control animals. Importantly, the combined 24\u2009h CVCES and antibiotic treatments resulted in no implant\u2010associated MRSA CFU enumerated in 83% of the animals (five out of six animals) and no bone\u2010associated MRSA CFU enumerated in 50% of the animals (three out of six animals). Overall, the outcomes of this study have shown that extended duration CVCES therapy is an effective adjunctive therapy to eradicate IAIs.<\/jats:p>","DOI":"10.1002\/jor.25625","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T09:20:13Z","timestamp":1684488013000},"page":"2756-2764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["In vitro and in vivo assessment of extended duration cathodic voltage\u2010controlled electrical stimulation for treatment of orthopedic implant\u2010associated infections"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9020-0388","authenticated-orcid":false,"given":"Kyle","family":"Weeks","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering University at Buffalo Buffalo New York 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