title: Antibiotic prophylaxis and infection resistance of massive tumor endoprostheses during chemotherapy.
abstract: Fifty-five consecutively treated patients with malignant bone tumors had preoperative and postoperative chemotherapy by one oncologist. These same patients had massive bone resection and cemented endoprosthetic bone replacement by one orthopaedic oncologist. Despite 143 instances of documented fever and/or neutropenia in 45 of these 55 patients, no known deep periprosthetic infections developed in any patient during follow-up (mean, 29.4 months; median, 25 months; range, 5 months to 62 months). Broad spectrum antibiotics had been administered in at least 118 instances to these patients (intravenously in hospital, 9 times to 7 patients; intravenously at home, 38 times to 18 patients; and orally at home, 71 times to 26 patients). This study confirms the low infection rate of these massive endoprostheses, despite neutropenic and/or febrile episodes if the patient is given prophylactic broad spectrum antibiotics during the episodes. We support the continued use of massive endoprostheses for bone reconstruction in patients requiring chemotherapy.
authors.affiliation: Department of Orthopaedic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1070, USA.
authors.forename: W G
authors.initials: WG
authors.lastname: Ward
authors.forename: K
authors.initials: K
authors.lastname: Johnston-Jones
authors.forename: S
authors.initials: S
authors.lastname: Lowenbraun
authors.forename: F
authors.initials: F
authors.lastname: Dorey
authors.forename: G
authors.initials: G
authors.lastname: Rosen
authors.forename: J J
authors.initials: JJ
authors.lastname: Eckardt
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents; D019072:Antibiotic Prophylaxis; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000276:immunology; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000276:immunology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000276:immunology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents