Systematic evaluation of antibiotic activity of a cefazolin-loaded scaffold with varying 3D printing temperatures and its application in treating osteomyelitis

Osteomyelitis is one of the most common inflammatory bone diseases caused by gram-positive bacteria. Although cefazolin is widely used as an osteomyelitis antibiotic against Staphylococcus aureus, its thermo-labile properties may decrease its antibiotic activity when incorporated into bone cement, such as poly-methyl methacrylate. Thus, to fully characterize the loss of antibiotic activity during the fused deposition modeling 3D-printing processes, we systematically evaluated the antibacterial activity of a cefazolin-loaded polycaprolactone (PCL)-based scaffold at varying 3D printing temperatures against S. aureus. In vitro antibacterial activity analysis revealed that cefazolin-loaded PCL scaffolds printed between 60 degrees C and 120 degrees C could maintain the antibacterial activity, whereas the antibacterial activity of scaffolds printed between 140 degrees C and 160 degrees C was significantly decreased. In addition, the therapeutic potential of the 3D-printed, scaffolds was assessed based on serum interleukin-6 (IL-6) levels, micro-computed tomography (micro-CT), and histological evaluation using a rabbit model of S. aureus-induced chronic osteomyelitis. Our in vivo results demonstrated that the serum level of IL-6 decreased in the cefazolin-loaded PCL scaffold-transplanted group. Furthermore, micro-CT and histological analyses confirmed the decreased deformation and overgrowth of the bone. The utilization of a 3D-printable, cefazolin-loaded PCL scaffold offers a promising and distinct approach for the treatment of osteomyelitis. C 2023 The Korean Society of Industrial and Engineering Chemistry. Published by Elsevier B.V. All rights reserved.