Guidelines for Complications of Cancer Treatment Vol VIII Part B

2. Another small prospective randomized trial comparingthe effect of cefuroxime impregnated cement versussystemic administration of cefuroxime found nostatistically significant difference in respect to incidenceof superficial or early deep wound infections betweenthe two groups 56 .3. Two trials (one in patients with diabetes mellitus) inpatients undergoing total knee arthroplasty comparinginfection rates in patients who received cefuroximeimpregnated bone cement and those who had standardbone cement found a significant reduction in deepinfections in the antibiotic cement group 57,58 .4. A large Norwegian study found that patients whoreceived both systemic prophylaxis and antibioticimpregnatedcement had the lowest risk of revision.Those who received only systemic antimicrobialprophylaxis had a revision rate because of infection thatwas 1.8 times higher. The authors concluded thatsystemic antibiotics, combined with antibioticimpregnatedcement, provide the best prophylaxis fortotal hip arthroplasty 59 .5. In a recent review, Bourne 54 suggested that considerationshould be given for use of antibiotic-impregnated bonecements during primary joint arthroplasty. Before theuse of antibiotic-impregnated cement can berecommended for routine primary joint arthroplasties,however, randomized trials are needed to study the rateof infection, the risk of antimicrobial resistance, andassessment of cost-benefit 8,54 . Antibiotic-impregnatedcement has a more definitive role in high-risk patients,such as the immunocompromised, the elderly, or thoserequiring revision surgeries 54 .6. In a study of 91 infected total hip arthroplasties causedby coagulase-negative staphylococci, emergence of133