# Ultrasound-Triggered Prophylaxis as a Novel Paradigm for Preventing Spinal Infection

> **NIH NIH R00** · THOMAS JEFFERSON UNIVERSITY · 2024 · $241,530

## Abstract

Bacterial infection following spinal fusion surgery is a major clinical concern, with 1-10% of patients
developing infection despite aggressive peri-operative antibiotic treatments. Upwards of 5 million annual spinal
surgeries are predicted by 2030. Current clinical standards involve the use of aseptic drains and packing of ~1g
of powdered vancomycin (VAN) into the wound space; however, this prophylaxis is short-lived (24-48 h). Left
untreated, persistent bacteria form biofilms on the spinal hardware, complicating treatment of the infection by
requiring aggressive systemic antibiotic treatment and removal of the infected hardware, prolonging hospital
admission and patient debilitation. More effective means to prevent infection are a clinical imperative. New
treatment modalities must eradicate pathogens prior to their adherence to the spinal hardware to be effective in
preventing infection. Based on our previous work, our hypothesis is that a time-dependent augmentation of the
initial VAN levels with a combination of antibiotics effective against both Gram-positive AND Gram-negative
bacteria will reduce spinal infection rates. We propose to develop an implantable hydrogel, which will augment
the standard period of aggressive antimicrobial prophylaxis through (1) sustained release of VAN at the surgical
site while surgical drains are still present to maintain prophylactic levels of antibiotics, and (2) following surgical
drain removal, external ultrasound-triggered release of a bolus of complementary broad-spectrum antibiotics
(VAN + tobramycin) from within the hydrogel to provide broad spectrum coverage against surviving bacteria.
Use of a combination of antibiotics is expected to reduce the risk of antibiotic resistant pathogens, while also
ensuring that all contaminating pathogens are eradicated from the surgical site. The scientific premise of this
work is that the proposed system will allow rapid, spatiotemporally-controlled, and complete release of antibiotics
at supra-therapeutic levels to reduce bacterial colonization of the surgical hardware. There are three specific
aims: 1) Characterize the release kinetics and stability of the hydrogel as well as the ultrasound-triggered
prophylactic release system using optimized ultrasound parameters, 2) Assess the ability of the ultrasound-
triggered system to prevent bacterial colonization of spinal hardware under in vitro conditions, and 3) Determine
the prophylactic utility of the ultrasound-triggered system in eradicating bacteria and preventing infection in an
in vivo model of spinal surgery. This proposed project addresses the clinical problem of postoperative spinal
infections using innovative applications of proven materials, and can quickly and effectively be translated to the
clinical area upon completion of the project. We anticipate that the project will result in an adjunctive therapy
capable of lowering infection rates in spinal fusion patients, effectively reducing the pain, disability...

## Key facts

- **NIH application ID:** 10910042
- **Project number:** 5R00AR078354-04
- **Recipient organization:** THOMAS JEFFERSON UNIVERSITY
- **Principal Investigator:** Lauren Jo Delaney
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $241,530
- **Award type:** 5
- **Project period:** 2021-09-10 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10910042

## Citation

> US National Institutes of Health, RePORTER application 10910042, Ultrasound-Triggered Prophylaxis as a Novel Paradigm for Preventing Spinal Infection (5R00AR078354-04). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10910042. Licensed CC0.

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