Summary

Antibiotic-loaded bone cements are used both for prophylaxis to prevent infections and as concomitant support of therapy for existing infections.

The rapid formation of a biofilm on endoprostheses and implants makes local antibiotic prophylaxis particularly important. The best results are achieved with the combination of systemic and local antibiotic prophylaxis. The use of local antibiotics can demonstrably lower rates of infection.

Local administration of antibiotics achieves high local concentrations of antibiotics with a lower systemic load. Implants and bone cement are thus protected against colonisation by microorganisms.

The release is affected by various factors. The ability of the bone cement to absorb water is of particular importance here. Different bone cements have differing release properties.

Not all antibiotics are suitable for use in bone cement. Gentamicin as well as gentamicin combined with clindamycin or vancomycin have proven to be particularly advantageous.

Industrially manufactured antibiotic-loaded bone cements are available in various combinations and dosages for primary and revision surgery. They have a number of advantages over manual addition of antibiotics.

Bone cement is not approved for manual addition of antibiotics.

This procedure is used in clinical practice but should be restricted in principle to exceptional cases.