title: Cost of antibiotic beads is justified: a study of open fracture wounds and chronic osteomyelitis.
abstract: BACKGROUND
  The purpose of this study was to track the cost of antibiotic-impregnated bead chains and the outcome of treatment over a 30-month period occurring before USP Chapter 797 went into effect. Our overall objective was to determine whether the costs of antibiotic beads were justified by reduced rates of active infections associated with open fracture wounds or chronic osteomyelitis.
  
  
  METHODS
  We retrospectively reviewed 125 patients with open fracture wounds (Group 1) and 16 patients with chronic osteomyelitis (Group 2) treated over a 2.5-year period. We reviewed the medical records and performed cost calculations for the beads. The minimum time from treatment to the latest follow-up evaluation was six weeks (average, 30.7 weeks; range, 6-134 weeks) for Group 1 and six months (average, 61.8 weeks; range, 24-156 weeks) for Group 2.
  
  
  RESULTS
  The overall infection rates were 3.2% (96.8% free of active infection) for Group 1 and 25.0% (75.0% free of active infection) for Group 2. The average cost of antibiotic bead treatment per patient was $419.36 for Group 1 and $484.54 for Group 2.
  
  
  CONCLUSIONS
  The costs of antibiotic beads to prevent active infection of open fracture wounds or to treat active infection associated with chronic osteomyelitis are justified based on the cost structure prior to the impact of new federal regulations (USP Chapter 797 regulations). We anticipate that the cost of antibiotic beads will increase dramatically with these new regulations.
authors.affiliation: Department of Orthopaedic Surgery, University of Louisville, School of Medicine, 210 E. Gray Street, Suite 1003, Louisville, KY, USA.
authors.forename: Brenton A
authors.initials: BA
authors.lastname: Wright
authors.forename: Craig S
authors.initials: CS
authors.lastname: Roberts
authors.forename: David
authors.initials: D
authors.lastname: Seligson
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Malkani
authors.forename: Steven J
authors.initials: SJ
authors.lastname: McCabe
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D002626:Chemistry, Pharmaceutical; D004343:Drug Implants / Q000191:economics*; D005597:Fractures, Open; D006801:Humans; D007880:Legislation, Drug; D010019:Osteomyelitis / Q000188:drug therapy*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D004343:Drug Implants