Prophylactic use of antibiotic bone cement: An emerging standard - In opposition

Arlen D. Hanssen

Research output: Contribution to journalArticlepeer-review

115 Scopus citations

Abstract

Antibiotic-loaded bone cement (ABLC) is an effective delivery method of local antibiotics. ABLC for treatment should be high dose (>3.6 g per 40 g cement) for beads or spacers and 1 to 2 g antibiotic per 40 g cement for prosthesis fixation. Multiple antibiotics are required for treatment, with antibiotics being individualized according to culture susceptibilities. This approach requires hand mixing because there are no commercial high-dose products. ABLC should be low dose (≤1 g per 40 g cement) for prophylaxis purposes. Concerns with toxicity and cement mechanical properties are inconsequential with low-dose ABLC. Available clinical evidence supports low-dose ABLC for prophylaxis in revisions and high-risk primary joints, but concerns of emerging drug-resistant organisms probably outweigh routine use of low-dose ABLC in all uncomplicated primary arthroplasties.

Original languageEnglish (US)
Pages (from-to)73-77
Number of pages5
JournalJournal of Arthroplasty
Volume19
Issue number4 SUPPL. 1
DOIs
StatePublished - Jun 1 2004

Keywords

  • Antibiotic prophylaxis
  • Antibiotic-loaded bone cement
  • Drug-resistant organisms
  • Primary arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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