2022, Vol. 26 ›› Issue (27): 4411-4416

Antibacterial agents loaded on hydroxyapatite scaffolds: action mechanism between the drug and the scaffold

Xu Ran1, Chen Xingyu1, Li Zhiqiang2     

Abstract: BACKGROUND: Local infections caused by the implantation of bone repair materials are one of the most serious postoperative complications. It is necessary to improve the effect of the antibacterial agent at the implantation site.
OBJECTIVE: To summarize the methods based on hydroxyapatite scaffolds carrying antibacterial drugs, the types of antibacterial drugs, and the mechanism of action between drugs and scaffolds, and summarize the development trend of the drug-loading system.
METHODS: The computer used to search the relevant articles included in the CNKI database, PubMed database and Web of Science database. The Chinese and English search terms were “hydroxyapatite, bone tissue engineering, bone repair, bone infection, drug delivery, antibacterial”. Review articles related to hydroxyapatite-based scaffold-loaded antibacterial drugs from January 1997 to January 2021 were involved, including reviews, basic research, and clinical studies.
RESULTS AND CONCLUSION: Loading antibacterial drugs on the hydroxyapatite composite scaffold material can effectively increase the local drug concentration, while avoiding systemic toxicity and better promoting bone tissue regeneration. Hydroxyapatite composite scaffold loaded antibacterial drugs have a good drug sustained release effect and anti-infective effect. However, the incorporation of drugs can potentially affect the mechanical properties of calcium phosphate scaffold materials. The current challenge in preparing antibacterial drug delivery systems is to load a sufficient amount of drug molecules while not affecting the mechanical properties of the carrier, while also considering the toxicity of the concentration to cells and tissues. The preparation process of tissue-engineered scaffolds needs to be further improved, and the interaction mechanism between drugs and scaffolds needs further investigation.
Key words: hydroxyapatite, bone repair, composite scaffold, drug controlled release, antibacterial drugs, postoperative infection