Antibiotic-laden bone cement

Mitchell MD, Brennan PJ, Mull NK
Record ID 32018005350
English
Authors' objectives: Identify health technology assessment reports and systematic reviews relating to antibiotic-laden bone cement, antibiotic beads or pellets, and related products for the treatment and prevention of bone infections in surgical patients.
Authors' results and conclusions: We conducted a limited search for high-level evidence on antibiotic-laden bone cement, beads, and related products for the treatment and prevention of infections in surgical patients. ▪ Four technology assessment reports were found. All of them addressed the prevention indication and not the treatment indication. They did not find conclusive evidence that antibiotic-laden cement reduces surgical site infections, though significant reductions in infections were found in a few trials. ECRI suggests that the reason may be that patients now routinely receive prophylactic antibiotics by other means, so the incremental effect of antibiotic cement may be small. ECRI also suggests limiting the prophylactic use of antibiotic-laden bone cement to patients considered to be at higher-risk for infection and its adverse consequences. ▪ At least 14 systematic reviews address the treatment indication. Most of them report on patients with infections following joint arthroplasty: some report on patients with chronic osteomyelitis. Most reviews concluded that the antibiotic products had a favorable effect on patient outcomes, but there was heterogeneity in results that suggests that effects differ for different groups of patients. ▪ None of the abstracts from these reviews report on the incremental effectiveness of antibiotic-laden bone cement in patients already being given systemic antibiotics. ▪ Use of antibiotic-laden bone spacers may be associated with increased risk of acute kidney injury.
Details
Project Status: Completed
Year Published: 2023
URL for published report: https://www.med.upenn.edu/CEP/external-request-form.html
Requestor: Chief Medical Officer
English language abstract: An English language summary is available
Publication Type: Other
Country: United States
MeSH Terms
  • Osteomyelitis
  • Polymethyl Methacrylate
  • Calcium Compounds
  • Antibiotic Prophylaxis
  • Bone Cements
  • Anti-Bacterial Agents
  • Arthroplasty
  • Arthroplasty, Replacement, Hip
  • Arthroplasty, Replacement, Knee
  • Surgical Wound Infection
Keywords
  • cement
  • beads
  • surgical site infection
  • antimicrobial
Contact
Organisation Name: Penn Medicine Center for Evidence-based Practice
Contact Address: Penn Medicine Center for Evidence-based Practice, University of Pennsylvania Health System, 3600 Civic Center Blvd, 3rd Floor West, Philadelphia PA 19104
Contact Name: Nikhil Mull
Contact Email: cep@pennmedicine.upenn.edu
Copyright: <p>Center for Evidence-based Practice (CEP)</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.