UNASSIGNED: Surgical implant-associated @entity79 ( @entity4034 ) have severe clinical and socioeconomic consequences. Treatment of chronic @entity79 often involves antibiotics given systemically and locally to the affected site in @entity4625 ( @entity4625 ) bone cement. Given the high antibiotic concentrations required to affect bacteria in biofilm, local delivery is important to achieve high doses at the infection site. @entity4625 is not suitable to locally-deliver some biofilm-specific antibiotics, including @entity1215 , due to interference with @entity4625 polymerisation. To examine the efficacy of localised, combinational antibiotic delivery compared to @entity4625 standards, we fabricated @entity1215 - and @entity2176 -laden @entity78 scaffolds (CPS) by three-dimensional (3D) printing to treat an implant-associated @entity794 @entity79 in a @entity19 model. All @entity2176 - and @entity1215 -laden CPS treatments significantly reduced the bacterial burden compared with @entity2176 -laden @entity4625 . The bones were bacteria culture negative in 50  % of the @entity19 that received sustained release @entity2176 - and @entity1215 -laden CPS. In contrast, 100  % of the bones treated with @entity2176 monotherapy using @entity4625 or CPS were culture positive. Yet, the monotherapy CPS significantly reduced the bacterial metabolic load following revision compared to @entity4625 . Biofilm persisted on the fixation hardware, but the infection-induced @entity79 was significantly reduced by local @entity1215 delivery. These data demonstrate that, despite the challenging implant-retaining infection model, co-delivery of @entity1215 and @entity2176 from 3D printed CPS, which is not possible with @entity4625 , significantly improved the outcomes of implant-associated @entity4034 . However, biofilm persistence on the fixation hardware reaffirms the importance of implant exchange or other biofilm eradication strategies to complement local antibiotics.

3D printed bioceramics for dual antibiotic delivery to treat implant-associated XXXX .

@entity4625 :: ('MESH:D019904', 'Chemical') :: ['PMMA', 'poly (methyl methacrylate)'] @entity2176 :: ('MESH:D014640', 'Chemical') :: ['vancomycin'] @entity19 :: ('10090', 'Species') :: ['mice', 'murine'] @entity4034 :: ('MESH:D010019', 'Disease') :: ['osteomyelitis'] @entity78 :: ('MESH:C020243', 'Chemical') :: ['calcium phosphate'] @entity794 :: ('1280', 'Species') :: ['Staphylococcus aureus'] @entity79 :: ('MESH:D001847', 'Disease') :: ['bone destruction', 'bone infections', 'bone infection'] @entity1215 :: ('MESH:D012293', 'Chemical') :: ['rifampin']
@entity79 :: (MESH:D001847,Disease) :: ['bone infection']
