JBJI Journal of Bone and Joint Infection JBJI J. Bone Joint Infect. 2206-3552 Ivyspring Göttingen, Germany 10.7150/jbji.39050 Antimicrobial Prophylaxis for the Prevention of Surgical Site Infections in Orthopaedic Oncology - A Narrative Review of Current Concepts Müller Daniel 1 Kaiser Dominik 1 Sairanen Kati 2 Studhalter Thorsten 3 Uçkay İlker 2 3 Department of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland Unit of Clinical and Applied Research, Balgrist University Hospital, Zurich, Switzerland Infectious Diseases and Infection Control, Balgrist University Hospital, Zurich, Switzerland 15 10 2019 4 6 254 263 Copyright: © 2019 Daniel Müller et al. 2019 This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/ This article is available from https://jbji.copernicus.org/articles/4/254/2019/jbji-4-254-2019.html The full text article is available as a PDF file from https://jbji.copernicus.org/articles/4/254/2019/jbji-4-254-2019.pdf

<p class="p p-first-last" id="__p3">The incidence of surgical site infections (SSIs) after elective tumour orthopaedic surgery in adults is higher than non-oncologic orthopaedic surgery. Their causative microorganisms and antibiotic susceptibilities are also different from the non-oncologic cases; with no apparent predictable microbiological patterns. Clinicians continue to struggle to tailor the optimal prophylactic regimen for the very heterogeneous group of tumour patients. Many clinicians thus prolong the first-and second-generation cephalosporin agents, while a minority chooses to broaden the antimicrobial spectrum by combination prophylaxis. The variability in current practices and surgical techniques is enormous, even within the same setting. The scientific literature lacks adequate retrospective case-studies and there is currently only one prospective randomized trial. In this narrative review, we discuss various perioperative antibiotic concepts in oncologic orthopaedic surgery, including a summary of the state-to-the-art, opinions and difficulties related to the different prophylactic strategies.</p>

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