Table 1a.

Natural Polymers for Local Antibiotic Delivery

Reference	Material	Antibiotic	Tx Time	Controls	Sample Size	Cultures	Primary Findings
(Itokazu et al., 1997)	Fibrin	Arbekacin sulfate (ABK)	13 wk	PBO, Untreated	6	Ground bone	Fibrin + ABK significantly reduced CFU vs. controls
(Mader et al., 2002)	Fibrin	Tobramycin	4 wk	Systemic tobramycin, PMMA, PBO, Untreated	15	Vortex bone chips & marrow	Fibrin, PMMA and systemic tobramycin had similar CFU counts; PMMA had the highest (−) culture rate
(Mendel et al., 2005)	Collagen	Gentamicin	4 wk	Systemic cefazolin (cef), PMMA +/− sys. cef., Collagen +/− sys. cef., Untreated	10–12	Ground bone	All Tx reduced CFU vs. untreated. Systemic cef. tended to additively augment local Tx. Collagen had 82% (−) cultures vs. 0% with PMMA
(Cevher et al., 2006; Orhan et al., 2006)	Chitosan or Pectin microspheres	Ciprofloxacin	3 wk	Systemic ciprofloxacin (cipro), PBO	8	Ground bone	Significant reduction in CFU by chitosan, but not pectin, vs. sys cipro; sys cipro was not different from PBO
(Stinner et al., 2010)	Chitosan sponge	Vancomycin	42 hr	Untreated	5	None	Vancomycin-chitosan sponge reduced bioluminescence of bacteria after 42 hrs of Tx
(Xing et al., 2013)	Alginate beads in fibrin gel	Vancomycin	3 mo	PBO	3	Biopsies in culture broth	100% (−) cultures for Vanco-beads vs. 0% for PBO; Tx improved radiographic scores.

PBO – Placebo (material without antibiotics); (−) – negative; Tx – treatment; sys – systemic