Abstract
Objective Erythromycin (Ery) and leech saliva (LS) can inhibit Staphylococcus aureus growth in in vitro conditions. This study aimed to evaluate the activities and synergy between Ery and
LS on chronic osteomyelitis in male Wistar rat's tibia induced by methicillin-resistant
S. aureus (MRSA).
Materials and Methods Four weeks after osteomyelitis induction, rats were divided into four groups including
no treatment (control), Ery monotherapy (orally), LS monotherapy, or Ery + LS twice
daily for 2 weeks. Staphylococcus aureus growth, pathological signs and inflammatory cytokine tumour necrosis factor-alpha
(TNF-α) levels were assessed.
Results Rats tolerated all therapeutic strategies well during the experiment. The Ery treatment
alone significantly decreased bacterial growth, pathological signs and TNF-α levels.
Leech saliva alone reduced TNF-α level significantly, but did not produce a significant
reduction in bacterial growth and pathological signs. Ery + LS treatment significantly
decreased bacterial growth, considerably alleviated bone pathological signs and decreased
TNF-α levels compared with other groups. Statistical analysis suggested that there
was a stronger efficiency and synergistic action of Ery and LS when combined against
MRSA-induced osteomyelitis in rats.
Clinical Significance The present study suggests that LS may have clinical utility to treat MRSA-induced
osteomyelitis when combined with Ery or other therapeutics.
Keywords
methicillin-resistant
Staphylococcus aureus
- osteomyelitis - leech therapy - erythromycin
