Short-Term Celecoxib Promotes Bone Formation without Compromising Cefazolin Efficacy in an Early Orthopaedic Device-Related Infection: Evidence from a Rat Model
Non-steroidal anti-inflammatory drugs (NSAIDs) are crucial components of multimodal analgesia for musculoskeletal injuries, targeting cyclooxygenase (COX) enzymes (COX-1 and/or COX-2 isoenzymes). Concerns exist regarding their potential interference with bone healing and orthopaedic device-related i...
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| Main Authors: | , , , , , , , , |
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| Format: | Book |
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MDPI AG,
2024-07-01T00:00:00Z.
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| Online Access: | Connect to this object online. |
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| Summary: | Non-steroidal anti-inflammatory drugs (NSAIDs) are crucial components of multimodal analgesia for musculoskeletal injuries, targeting cyclooxygenase (COX) enzymes (COX-1 and/or COX-2 isoenzymes). Concerns exist regarding their potential interference with bone healing and orthopaedic device-related infections (ODRI), where data are limited. This study aimed to investigate whether the COX-selectivity of NSAIDs interfered with antibiotic efficacy and bone changes in the setting of an ODRI. In vitro testing demonstrated that combining celecoxib (a COX-2 inhibitor) with cefazolin significantly enhanced antibacterial efficacy compared to cefazolin alone (<i>p</i> < 0.0001). In vivo experiments were performed using <i>Staphylococcus epidermidis</i> in the rat proximal tibia of an ODRI model. Long and short durations of celecoxib treatment in combination with antibiotics were compared to a control group receiving an antibiotic only. The long celecoxib treatment group showed impaired infection clearance, while the short celecoxib treatment showed increased bone formation (day 6, <i>p</i> < 0.0001), lower bone resorption (day 6, <i>p</i> < 0.0001), and lower osteolysis (day 6, BV/TV: <i>p</i> < 0.0001; BIC: <i>p</i> = 0.0005) compared to the control group, without impairing antibiotic efficacy (<i>p</i> > 0.9999). Given the use of NSAIDs as part of multimodal analgesia, and considering these findings, short-term use of COX-2 selective NSAIDs like celecoxib not only aids pain management but also promotes favorable bone changes during ODRI. |
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| Item Description: | 10.3390/antibiotics13080715 2079-6382 |