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Why Gentamicin is suitable for local antibiotics?

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* If the blood concentration is high, reduce the dosage concentration.

*Daily dose affects blood concentration.

* Flow rate is affected the time to reach plateau at serum antibiotics concentration.

60mg Gentamicin/50ml saline=1200μg/ml

2ml/h infusion speed

 The antibacterial agent used for CLAP  is suitable for topical administration because it can be expected to have a bactericidal effect by increasing the concentration of the "bactericidal" and "concentration-dependent" antibacterial agent. Aminoglycosides or quinolones fit under this category, and aminoglycosides have been used clinically for a long time and basic data have been reported. Of these, the concentrations that can be easily measured in clinical settings, gentamicin is suitable for CLAP. ​Since resistant bacteria can be suppressed by high-concentration of amynoglycoside. First choice for CLAP is 'gentamicin' regardless of pathogen. If the gentamicin is not effective, other aminoglycoside agent arbekacinI should be the candidate.


In addition, intravenous administration of antibiotics is always applied during the CLAP treatment period. Theoretically, antibiotics should not be necessary during topical administration, only if they reach the infected wounds for whole area. But it can be assumed that not all infected foci are actually reached. It should also be effective against bacteria floating in the blood. Therefore, systemic administration is recommended for pathogenic bacteria depend on their susceptibility.  Next, regarding the period of intravenous administration, when antimicrobial agents are used to control infection in open fractures, intravenous administration should also be discontinued when CLAP is terminated. However, if infection is established, antibiotic administration for 2 to 3 months will be required according to chronic osteomyelitis.

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