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Percutaneous treatment of chronic MRSA osteomyelitis with a novel plant-derived antiseptic
© Sherry et al; licensee BioMed Central Ltd. 2001
Received: 17 March 2001
Accepted: 16 May 2001
Published: 16 May 2001
Antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE, are an increasing problem world-wide, causing intractable wound infections. Complex phytochemical extracts such as tea tree oil and eucalypt-derived formulations have been shown to have strong bactericidal activity against MRSA in vitro. Polytoxinol (PT) antimicrobial, is the trade name of a range of antimicrobial preparations in solution, ointment and cream form.
We report the first use of this drug, administered percutaneously, via calcium sulphate pellets (Osteoset,TM), into bone, to treat an intractable MRSA infection of the lower tibia in an adult male.
Results and Discussion
Over a three month period his symptoms resolved with a healing response on x-ray and with a reduced CRP.
Antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE), are an increasing problem world-wide, causing intractable wound infections [1,2]. Complex phytochemical extracts such as tea tree oil and eucalypt-derived formulations  have been shown to have strong bactericidal activity against MRSA in vitro. Polytoxinol™ (PT) antimicrobial, is the trade name of a range of antimicrobial preparations in solution, ointment and cream form. We report the first use of this drug, administered percutaneously, via calcium sulphate pellets (Osteoset™), into bone, to treat an intractable MRSA infection of the lower tibia in an adult male.
Once antibiotics fail, treatment options are limited to debridement, removal of hardware, or amputation. The active ingredients are compounded Phytochemicals (Lemongrass, Eucalyptus, Melaleuca, Clove, Thyme as well as B.H.T. (Butylated Hydroxy Toluene), Triclosan (0.3%) and 95 undematured ethano (69.7%).
Antibiotic-resistant Gram-positive cocci, especially MRSA, causing wound infections are of great concern as they cause increased mortality rates, hospitalisation and longer treatment to discharge times . This is especially so in orthopaedic surgery with the use of internal fixation and prosthetic devices as bacteria compete with host cells to colonise these foreign surfaces . Aggressive prophylaxis with antibiotics and optimised surgical strategies can reduce the frequency of MRSA infections [2,5], although increasing the cost of surgery.
PT is a complex chemical mixture and the biological activity of its major components, tea tree oil and eucalyptus, [6,7] have been described. A recent paper by Anderson and Fennessy reviewed and concluded that there was compelling in vitro evidence of the effectiveness of tea tree oil against MRSA; here we add a clinical case . This case report describes a cheap, simple technique as a possible alternative to long-term systemic antibiotic therapy. Here it was administered percutaneously over calcium sulphate pellets and then topped-up via a catheter. It may also be used topically. The beads were used as a vehicle for PT and as a bone graft. More extensive case studies or a randomised controlled trial are now suggested.
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