{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:12:17Z","timestamp":1790572337784,"version":"4.1.0"},"reference-count":92,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Systems Research Institute (HSRI), Thailand","award":["HSRI 63-056"],"award-info":[{"award-number":["HSRI 63-056"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Chronic osteomyelitis is still a serious health problem that causes disabling conditions and has an impact on the quality of life. The objective of this study was to determine the clinical efficacy and safety of localized antibiotics delivery via impregnated microporous nanohydroxyapatite (nHA-ATB) beads for chronic osteomyelitis treatment. A total of 62 patients were enrolled in this study. After radical surgical debridement, the bone defect was filled with three types of antibiotics (vancomycin or gentamicin or fosfomycin) impregnated HA beads. The follow-up period was 48 weeks. It was found that the success rate was approximately 98% with a re-infection in only one patient. Quality of life of all patients after treatment improved significantly over time. Systemic exposure to vancomycin and gentamicin after beads implantation was limited and high local antibiotics concentrations were found in wound drainage fluid at 24, 48 and 72 h. Blood biochemistry measurements did not show any nephrotoxic or hepatotoxic effects. 20 adverse events were reported, but 90% of the events were resolved without having to remove the beads and the patients recovered. Satisfactory outcomes were observed in terms of success rate, quality of life and adverse effect. nHA-ATB beads impregnated by vancomycin or gentamicin or fosfomycin could potentially be employed as an alternative product of choice for localized antibiotics delivery in chronic osteomyelitis treatment.<\/jats:p>","DOI":"10.3390\/antibiotics12061049","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T01:32:57Z","timestamp":1686792777000},"page":"1049","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Efficacy and Safety of Antibiotic Impregnated Microporous Nanohydroxyapatite Beads for Chronic Osteomyelitis Treatment: A Multicenter, Open-Label, Prospective Cohort Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Chittawee","family":"Jiamton","sequence":"first","affiliation":[{"name":"Institute of Orthopaedics, Lerdsin Hospital, Silom Road, Bang Rak, Bangkok 10500, Thailand"},{"name":"Queen Savang Vadhana Memorial Hospital, Jerm Jom Phon Road, Tambon Si Racha, Si Racha, Chonburi 20110, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adinun","family":"Apivatgaroon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine, Thammasat University, Paholyothin Road, Klong Nueng, Klong Luang, Pathum Thani 12121, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saree","family":"Aunaramwat","sequence":"additional","affiliation":[{"name":"Paholpolpayuhasena Hospital, Sangchuto Road, Pak Phraek, Mueang, Kanchanaburi 71000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banchai","family":"Chawalitrujiwong","sequence":"additional","affiliation":[{"name":"Suppasitthiprasong Hospital, Sappasit Road, Nai Mueang, Mueang, Ubon Ratchathani 34000, 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Na","family":"Nakorn","sequence":"additional","affiliation":[{"name":"Hatyai Hospital, Ratthakan, Tambon Hat Yai, Hat Yai, Songkhla 90110, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Worawit","family":"Ongbumrungphan","sequence":"additional","affiliation":[{"name":"Bhumibol Adulyadej Hospital, Phahonyothin Road, Sai Mai, Bangkok 10220, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawin","family":"Rattanasumrit","sequence":"additional","affiliation":[{"name":"Bhumibol Adulyadej Hospital, Phahonyothin Road, Sai Mai, Bangkok 10220, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suthee","family":"Tharakulphan","sequence":"additional","affiliation":[{"name":"Khon Kaen Hospital, Sri Chant Road, Nai Mueang, Mueang, Khon Kaen 40000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanachai","family":"Thongtanworapat","sequence":"additional","affiliation":[{"name":"Pathumtani Hospital, Lat Lum Kaeo Road, Bang Prok, Muang, Pathum Thani 12000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faungchat","family":"Thammarakcharoen","sequence":"additional","affiliation":[{"name":"National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), 111 Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Autcharaporn","family":"Srion","sequence":"additional","affiliation":[{"name":"National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), 111 Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5555-3927","authenticated-orcid":false,"given":"Jintamai","family":"Suwanprateeb","sequence":"additional","affiliation":[{"name":"National Metal and Materials Technology Center (MTEC), National Science and Technology Development Agency (NSTDA), 111 Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani 12120, Thailand"},{"name":"Thammasat University Center of Excellence in Computational Mechanics and Medical Engineering, Thammasat University, Phahonyothin Road, Khlong Nueng, Khlong Luang, Pathum Thani 12121, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bancha","family":"Chernchujit","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine, Thammasat University, Paholyothin Road, Klong Nueng, Klong Luang, Pathum Thani 12121, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"key":"ref_1","first-page":"135","article-title":"How much does an infected fracture cost?","volume":"10","author":"Thahir","year":"2022","journal-title":"Arch. 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