Abstract
Osteomyelitis is commonly caused by Staphylococcus aureus. Both erythromycin and curcumin can suppress S. aureus growth, but their roles in osteomyelitis are barely studied. We aim to explore the activities of erythromycin and curcumin against chronical osteomyelitis induced by methicillin-resistant S. aureus (MRSA). Chronicle implant-induced osteomyelitis was established by MRSA infection in male Wistar rats. Four weeks after bacterial inoculation, rats received no treatment, erythromycin monotherapy, curcumin monotherapy, or erythromycin plus curcumin twice daily for 2 weeks. Bacterial levels, bone infection status, inflammatory signals and side effects were evaluated. Rats tolerated all treatments well, with no death or side effects such as, diarrhea and weight loss. Two days after treatment completion, erythromycin monotherapy did not suppress bacterial growth and had no effect in bone infection, although it reduced serum pro-inflammatory cytokines tumor necrosis factor (TNF)-α and interleukin (IL)-6. Curcumin monotherapy slightly suppressed bacterial growth, alleviated bone infection and reduced TNF-α and IL-6. Erythromycin and curcumin combined treatment markedly suppressed bacterial growth, substantially alleviated bone infection and reduced TNF-α and IL-6. Combination of erythromycin and curcumin lead a much stronger efficiency against MRSA induced osteomyelitis in rats than monotherapy. Our study suggests that erythromycin and curcumin could be a new combination for treating MRSA induced osteomyelitis.
Highlights
Staphylococcus aureus is the most common pathological microorganism that causes osteomyelitis (Lew and Waldvogel, 2004)
We explored the efficacies and side effects of erythromycin monotherapy, curcumin monotherapy, and erythromycin and curcumin combined therapy in a rat implant-induced osteomyelitis model caused by methicillin-resistant S. aureus (MRSA) infection
We observed a significant increase of body weight from 2 weeks post treatment when rats were treated with erythromycin alone or a combination of erythromycin and curcumin, compared to that of control group (Figure 1)
Summary
Staphylococcus aureus is the most common pathological microorganism that causes osteomyelitis (Lew and Waldvogel, 2004). Effective treatment for osteomyelitis is still lacking due to the formation of biofilm rendering it difficult for sufficient antibiotics to reach the local infection area as well as the development of resistance to antibiotic treatment. Development of new safe and effective therapeutic strategies is highly demanded to overcome drug-resistant bacterial strains and adverse side effects. One such strategy is combination of different antibiotics or with plant derived natural products (Coutinho et al, 2009; Bezerra Dos Santos et al, 2015). Erythromycin is broadly used to treat infections caused by various bacteria, including S. aureus (Jelic and Antolovic, 2016).
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