Despite extended, aggressive use of conventional antibiotics, drug treatment of bone infections
frequently fails as a combined result of the widespread of drug-resistant bacteria, poor accessibility
of many antimicrobials to the deeper portion of the bones, the ease of biofilm formation on the bone
surface, and high risk of drug toxicity. Emerging therapeutic nanotechnology offers potential solutions
to these issues. In recent years, a number of nanoantimicrobials, i.e. nanoscale devices with intrinsic
antibacterial activities or capacity for delivering antibiotics, have been developed for the treatment and
prevention of bone infections. These nanoantimicrobials can be designed to have controlled and sustained
drug release kinetics, surface-modifications for bone or bacteria targeting, and increased affinity
for biofilms. Given the potential value of nanoantimicrobials, clinical application of nanoantimicrobials
for bone infection treatment remains scant when compared with the number of ongoing research. It is,
therefore, a good time to carefully examine this promising yet relatively uncharted area. This review
will extensively discuss the development and state of the art of different classes of nanoantimicrobials
for bone infections with emphasis on the treatment aspect and identify the factors that prevent the clinical
translation of nanoantimicrobial therapy from bench to bedside.
Keywords: Osteomyelitis, antibiotics, nanotechnology, nanoantimicrobial, drug delivery, targeted delivery, bone.
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