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Vet Comp Orthop Traumatol 2020; 33(04): 243-251
DOI: 10.1055/s-0040-1703008
Original Research
Georg Thieme Verlag KG Stuttgart · New York

Co-administration of Erythromycin and Leech Salivary Extract Alleviates Osteomyelitis in Rats Induced by Methicillin-Resistant Staphylococcus aureus

Bahar Gerivani
1   Department of Pathobiology, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran (the Islamic Republic of)
,
Hamid Staji 
1   Department of Pathobiology, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran (the Islamic Republic of)
,
Maryam Rassouli
1   Department of Pathobiology, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran (the Islamic Republic of)
,
Nooshin Ghazaleh
2   Department of Clinical Sciences, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran (the Islamic Republic of)
,
Abbas Javaheri Vayeghan
1   Department of Pathobiology, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran (the Islamic Republic of)
› Author Affiliations
Further Information

Publication History

13 February 2019

18 January 2020

Publication Date:
30 April 2020 (online)

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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

Authors' Contributions

Hamid Staji and Maryam Rassouli generated hypothesis, experimental design, real-time polymerase chain reaction experiment and LS extraction. Bahareh Gerivani, Nooshin Ghazaleh and Abbas Javaheri Vayeghan conducted the experiments including surgery, pathology and enzyme-linked immunosorbent assay. Hamid Staji and Maryam Rassouli interpreted and analysed the results and wrote the manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for author contributions for this manuscript, take responsibility for the integrity of the work as a whole and have given final approval to the version to be published.