Antibiotics and cements for the prevention of biofilm-associated infections

Placement within the surgical site of cement loaded with antibiotics may help to maintain a high concentration of a drug at a local level. This concentration cannot be reached by standard venous administration without risking further complications and toxicity. Nevertheless, how effective the antibiotic-loaded cement can be is under debate. After surgery and site cleaning, the systemic administering of antibiotics for a prolonged time is mandatory, in order to prevent nosocomial infection. There are still many doubts and disagreements about several aspects of the use of antibiotic cement. This chapter will review key issues including: the method of preparation; the choice of antibiotic; the effective release and diffusion of the antibiotic in the surrounding tissues; and the mechanical properties of the antibiotic-loaded cement.