Chitosan coating to enhance the therapeutic efficacy of calcium sulfate-based antibiotic therapy in the treatment of chronic osteomyelitis

J Biomater Appl. 2014 Oct;29(4):514-23. doi: 10.1177/0885328214535452. Epub 2014 May 21.


We demonstrate that coating calcium sulfate with deacetylated chitosan enhances the elution profile of daptomycin by prolonging the period during which high concentrations of antibiotic are released. Coatings reduced initial bolus release of daptomycin by a factor of 10 to approximately 1000 µg/ml, and levels remained above 100 µg/ml for up to 10 days. Chitosan-coated and uncoated calcium sulfate implants with and without 15% daptomycin were evaluated in an experimental model of staphylococcal osteomyelitis through bacteriology scores, radiology, histopathology, and Gram staining. Significant reduction in bacteriology scores was observed for implants containing daptomycin and coated with chitosan compared with all the other groups. We confirm that the use of chitosan-coated calcium sulfate beads for local antibiotic delivery can be correlated with an improved therapeutic outcome following surgical debridement in the treatment of chronic osteomyelitis.

Keywords: Calcium sulfate; bone; chitosan; daptomycin; infection; local drug delivery; osteomyelitis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage*
  • Calcium Sulfate / chemistry
  • Chitosan / chemistry*
  • Chronic Disease
  • Coated Materials, Biocompatible / chemistry
  • Daptomycin / administration & dosage
  • Disease Models, Animal
  • Drug Delivery Systems
  • Male
  • Materials Testing
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / microbiology
  • Polymethyl Methacrylate / chemistry
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / microbiology
  • Rabbits
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology


  • Anti-Bacterial Agents
  • Coated Materials, Biocompatible
  • Polymethyl Methacrylate
  • Chitosan
  • Daptomycin
  • Calcium Sulfate