Evidence map›Paper›PMID 41379814›Full record

ArticlePloS one2025

Delayed delivery of antibiotics by ultrasound-mediated rupture of polylactic acid pockets: In vitro and in vivo studies.

Selin Isguven Billmyer, Priscilla Machado, Ryan E Tomlinson, Lauren J Delaney, Ji-Bin Liu, Alexander H Harris, Eric McLaughlin, Noreen J Hickok, Flemming Forsberg

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Selin Isguven BillmyerDepartment of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
Priscilla MachadoDepartment of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
Ryan E TomlinsonDepartment of Orthopedics, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0002-6713-6047
Lauren J DelaneyDepartment of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
Ji-Bin LiuDepartment of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
Alexander H HarrisDepartment of Orthopedics, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.ORCID https://orcid.org/0009-0003-7012-9950
Eric McLaughlinDepartment of Orthopedics, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.
Noreen J HickokDepartment of Orthopedics, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0001-8501-2817
Flemming ForsbergDepartment of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0003-2215-1371

Funding

Preventing Spinal Infection: Ultrasound Triggered ProphylaxisR01AR069119 · NIAMS · THOMAS JEFFERSON UNIVERSITY · PI Flemming Forsberg, Noreen J Hickok · 2016 to 2026
$3.2M
Ultrasound-Triggered Prophylaxis as a Novel Paradigm for Preventing Spinal InfectionR00AR078354 · NIAMS · THOMAS JEFFERSON UNIVERSITY · PI DELANEY, LAUREN JO · 2022 to 2024
$740k
NIAMS NIH HHS R00 AR078354NIAMS NIH HHS R01 AR069119
6 · The paper itself

Abstract

Surgical site infections are a devastating complication of instrumented orthopaedic surgery, particularly in the spine. Bacterial biofilms, once formed on the implant surfaces, exhibit antibiotic tolerance and immune escape, which lead to treatment challenges. Up to 9% of instrumented spine surgeries result in infection, despite the use of systemic antibiotics and local, powdered antibiotics for prophylaxis. The bacteria that survive the initial prophylaxis may be susceptible to a second, high dose of antibiotic prophylaxis prior to establishing at the site. Hence, we designed a local drug delivery system consisting of polylactic acid (PLA) film pockets that can be noninvasively triggered (i.e., ruptured) by the external application of ultrasound (US) following a delay of up to 6 days. We found that thin PLA films (24 ± 4.5 µm) with embedded vancomycin (VAN) powder assembled in a conical pocket shape best allowed for stability and rupturability of this US-mediated delivery system in vitro (92% US-triggered rupture of PLA-VAN pockets vs 31% of neat PLA pockets, p < 0.0001). VAN-embedded PLA films exhibited decreased strength and toughness (3.47 J/mm3 vs 0.68 J/mm3, p < 0.0001) and surface VAN was rapidly released upon submersion, adding an additional layer of protection against bacterial colonization of the device. Finally, a pilot in vivo study in five rabbits demonstrated the feasibility of the design, but the stability of neat PLA and PLA-VAN pockets were varied (9/15 of all pockets were intact by Day 3). All of the 5 intact pockets (3 neat PLA and 2 PLA-VAN) that were allocated for insonation ruptured following US (100%). Overall, this design has the potential for use in targeting orthopaedic infections as well as for US-triggered bolus drug release for prophylaxis in high risk cases.

Indexed as

Anti-Bacterial AgentsDrug Delivery SystemsPolyestersSurgical Wound InfectionUltrasonic WavesVancomycinAnimalsBiofilmsRabbitsAnti-Bacterial AgentsPolyesterspoly(lactide)Vancomycin

Identifiers

PMID41379814
PMCPMC12698016

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.