[Gentamicin in orthopedic surgery].

Like in other operative disciplines also in orthopedic surgery we can see an icrease of infections with gramnegative bacterial like ps. pyocyanea. Gentamicin is in general very effective against these infections. There are following indications for the use of Gentamicin in orthopedic surgery: 1. Parenteral administration only is indicated if there is no other less toxic antibiotic. If it is used a high dosage is necessary because the bone levels which we investigated were very low. Side effects have to be observed. 2. For local therapy Gentamicin is used in the suction and perfusion system in addition to a systemic therapy with Penicillin, Ampicillin or Cephalosporin. Gentamicin can also be used for the wound perfusion. 3. Added to bone cement Gentamicin should only be taken, when an infected total hip is exchanged or if a hospitalism with ps. pyocyanea is known- The administration of Gentamicin is less indicated : 1. Asthe only antibiotic for parenteral therapy in bone infection. 2. Added to bone cement for a general prophylaxis in all endoprosthetic operations.