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, 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 antibiotic in the infected site, which
can lead 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 cement, beads, scaffold 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.