Antibiotic-impregnated beads. Part II: Factors in antibiotic selection.

Part I of this series discussed the advantages of implanted antibiotic-impregnated polymethylmethacrylate beads over systemic therapy for managing chronic osteomyelitis and acute musculoskeletal infections. Numerous antibiotics are available for use in polymethylmethacrylate. However, specific characteristics should be considered prior to therapeutic selection: the antibiotic should be water-soluble, bactericidal, nontoxic to tissues, and readily available in powder form. In this concluding segment, the organisms most commonly cultured from orthopaedic infections and appropriate combinations of antibiotics and bone cements are outlined.