Osteomyelitis is a bone marrow infection which generally involves cortical plates and
which may occur after bone trauma, orthopedic/maxillofacial surgery or after vascular insufficiency
episodes. It mostly affects people from the Third World Countries, the elderly and patients affected
by systemic diseases e.g. autoimmune disorders, AIDS, osteoporosis and microvascular disease.
The highest percentage of osteomyelitis cases (almost 75%) is caused by Staphylococcus spp.,
and in particular by Staphylococcus aureus (more than 50%). The ideal classification and the diagnosis
of osteomyelitis are two important tools which help the physicians to choose the best therapeutic
strategies. Currently, common therapies provide an extensive debridement in association
with intravenous administration of antibiotics (penicillin or clindamycin, vancomycin and fluoroquinolones
among all for resistant microorganisms), to avoid the formation of sequestra. However,
conventional therapeutic approach involves several drawbacks like low concentration of antibiotics
in the infected site, leading to resistance and adverse effects due to the intravenous administration.
For these reasons, in the last years several studies have been focused on the development of drug
delivery systems such as cements, beads, scaffolds and ceramics made of hydroxyapatite (HA), calcium
phosphate (CaP) and β-tricalcium phosphate (β-TCP) which demonstrated to be biocompatible,
poorly toxic and capable to allow osteointegration and a prolonged drug release. The aim of
this review is to provide a focus on current therapies and latest developed drug delivery systems
with particular attention on those based on CaP and its derivatives, hoping that this work could allow
further direction in the field of osteomyelitis.