A Novel Transdermal Delivery Technology to Expedite Wound Healing and Attenuate Carbapenem-Resistant Acinetobacter baumannii Bacterial Infections
Abstract
Objectives and Rationale: Wound infections are a common cause of morbidity and mortality in combat casualty care as well as civilian trauma. Traumatic injuries break the protective barrier of the skin allowing bacteria to initially colonize and ultimately infect wounds. Combat sustained wounds are particularly unique due to the destructive force applied during wounding and the dirty environment of battle. A complicating factor is that many of the existing antibiotics are no longer effective against bacteria due to drug resistance and the emergence of so called superbugs. This has created a growing public health crisis for the combat wounded, Veterans and civilians alike. For the military, the emergence of antimicrobial resistance among bacteria affecting combat-related injuries is a serious problem with major regional and global implications. The initial wound management and surgical care of combat-injured military personnel and the chronic wound care of Veterans would benefit from novel treatment paradigm to both help preventing and treating infections of wounds caused by antibiotic resistant bacteria. Focus Area: Droplette micromist technology device (DMTD) is a small portable device developed and patented by Droplette, Inc., and provided to the CoI (Pulakat) via a Material Transfer Agreement between Tufts Medical Center and Droplette, Inc., (both institutions at Boston). Based on our published and preliminary data, we propose that we can deliver high molecular weight, broad spectrum antibiotics that are used to treat antibiotic resistant bacteria to treat infections by one of the most notorious biofilm forming multi-drug resistant pathogen, Acinetobacter baumannii. Thus our study will fit into the focus area: Understanding appropriate wound prophylaxis/empiric treatment strategies throughout continuum of care, regardless of injury status, through preclinical and clinical studies to inform clinical practice guidelines for expanding the understanding of antibiotic use in tissue injury (e.g., systemic versus topical), especially in the context of hemorrhage/resuscitation, blast, and/or delayed evacuation times. Potential Research and Clinical Applications, Benefits, and Risks: The antibiotics used to treat superbug infections, though powerful against the drug-resistant bacteria, can cause organ toxicity when administrated intravenously. These drugs also have high molecular weight, thus are unable to penetrate skin to reach the bacteria causing the infections deep in the wounds. As a result, they can only be administrated intravenously. We are proposing to test localized transdermal delivery of high molecular weight, broad spectrum antibiotic to treat infections by multi-drug-resistant Acinetobacter baumannii, thus minimizing the toxicity to the patient. Projected Timeline: We will optimize the dosing regimen of drug administration in the first year, then test the safety and efficacy of the treatment regimen in both a small animal (rat) and a large animal (pig) infection model in year 2 and 3 to validate the utility of this novel device in wound care. These animal studies are necessary steps before human clinical trials. We expect to demonstrate and validate the usefulness of DMTD in delivering these life-saving powerful drugs to fight antibiotic resistant pathogens and reducing their toxicity at the same time before the end of the project, and prepare proposals to support future clinical studies to bring this treatment ready for military adoption. It is estimated that it will take about 2-3 years to finish the clinical trials and 18 months to get the FDA approval for this technology to be applied to patient care. Benefit Service Members, and/or the American Public: This technology could reduce the morbidity and mortality not only of active-duty military suffering from combat associated wounds, but Veterans and the general public who may suffer from chronic wounds such as diabetic or pressu
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310841
Entities
People
- Hongmin Sun
Organizations
- Curators of the University of Missouri
- United States Army