Antimicrobial approaches for preventing infections associated with surgical implants

Because management of infections associated with surgical implants can be both difficult and costly, prevention of such infections remains a priority. Preventive strategies comprise systemic perioperative administration of antibiotics and local application of antimicrobial agents (antibiotics or antiseptics). Local antimicrobial prophylaxis can be provided in various forms and aims to prevent implant-associated infections by impeding bacterial adherence to the implant surface and/or reducing the concentration of bacteria in the immediate vicinity of the implant. Analysis of the existing clinical practices and the pertinent medical literature indicates that, although some antimicrobial strategies constitute the standard of care for preventing infections associated with surgical implants, such strategies are often applied in a nonstandardized fashion and without clear evidence of clinical efficacy. This review article concludes with a perspective on assessing and preventing such serious infections.