Calcium Phosphate Nanoparticles: a Future Therapeutic Platform for the Treatment of osteomyelitis?

Abstract

“‘It is hard to be brave’, said Piglet, sniffing slightly, ‘when you’re only a very small animal’. Rabbit, who had begun to write very busily, looked up and said: ‘It is because you are a very small animal that you will be useful in the adventure before us’.” Alan Alexander Milne, Winnie-the-Pooh and All, All, All Osteomyelitis, one of the oldest documented diseases, the descriptions of which date back to times of Hippocrates [1], is an illness particularly prevalent among elderly, diabetics, children and indigenes of Third World countries. Although morbidity due to chronic bone infection has drastically dropped from the pre-penicillin era, down to approximately 3% in the last 20 years [2], it is still high on the global scale and the disease continues to be challenging to treat [3]. Furthermore, the number of hip and knee replacement procedures performed in the USA has doubled in the past decade, while the number of the reported cases of bone infection accompanying those has been increasing in proportion with the number of surgeries performed [4], signifying the anticipated increase in the incidence rate of this illness in the future. The standard therapy for osteomyelitis has been based on the combination of repetitive intravenous or oral delivery of antibiotics over the period of a few weeks to a few months, depending of the severity of the infection, and surgical debridement of necrotic bone [5]. This clinical approach has had its obvious disadvantages, predominantly in terms of: