Applications of Local Antibiotics in Orthopedic Trauma

Orthop Clin North Am. 2015 Oct;46(4):495-510. doi: 10.1016/j.ocl.2015.06.010. Epub 2015 Aug 6.

Abstract

Local antibiotics have a role in orthopedic trauma for both infection prophylaxis and treatment. They provide the advantage of high local antibiotic concentration without excessive systemic levels. Nonabsorbable polymethylmethacrylate (PMMA) is a popular antibiotic carrier, but absorbable options including bone graft, bone graft substitutes, and polymers have gained acceptance. Simple aqueous antibiotic solutions continue to be investigated and appear to be clinically effective. For established infections, such as osteomyelitis, a combination of surgical debridement with local and systemic antibiotics seems to represent the most effective treatment at this time. Further investigation of more effective local antibiotic utilization is ongoing.

Keywords: Antibiotics; Bead; Infection; Local; Prophylaxis; Trauma.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Infective Agents, Local / administration & dosage*
  • Bacterial Infections / etiology
  • Bacterial Infections / therapy*
  • Biofilms / drug effects
  • Drug Carriers
  • Drug Delivery Systems*
  • Fractures, Bone / complications*
  • Humans
  • Osteomyelitis / etiology
  • Osteomyelitis / therapy

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Drug Carriers