Do Antibiotic Beads Need to be Removed?

Polymethylmethacrylate antibiotic impregnated beads can be an effective treatment for chronicosteomyelitis or an adjuvant in the treatment of open fractures. It remains unclear however whether the beads causelong-term adverse events if not removed. The purpose of this study was to determine if removal of antibiotic beads wasrequired in order to avoid long term complications. A retrospective chart review was conducted on patients with an extremity or pelvis fracture that hadimplantation of polymethylmethacrylate (PMMA) antibiotic beads over a five-year period. Fifty-one patients met inclusion criteria for this study; thirty-seven patients (73%) did not have complicationsafter surgical debridement and placement of PMMA antibiotic beads necessitating removal. Our findings suggest that polymethylmethacrylate antibiotic beads can be utilized as a means of deliveringhigh-dose concentrations of local antibiotics and do not have to be removed in all patients.Level of evidence: III