. 2015 Oct 5;2015:387186. doi: 10.1155/2015/387186

Table 2.

The benefits and drawbacks of antibiotic cement nails.

Benefits	Drawbacks
High concentration of local antibiotic elution: up to 200 times greater than with systemic drug administration, independent of vascular supply [21] Stability to the fracture/nonunion site, allowing for early weight bearing [23] Local antibiotic delivery independent of patient compliance [23] Systemic toxicity of antibiotics very rarely observed [8] Versatility of modifying antibiotic as per the culture report [27] Control of infection and stability is achieved with a single procedure [44] Alternative for patients refusing or not being right candidates for external fixation [13]	Local antibiotic carriers have never been shown to be superior to intravenous administration of antibiotics in terms of cure rate [21] Require repeat surgery [23] Possible emergence of resistance [13] Possible MMA toxicity [102, 103]

Benefits

Drawbacks

High concentration of local antibiotic elution: up to 200 times greater than with systemic drug administration, independent of vascular supply [21]
Stability to the fracture/nonunion site, allowing for early weight bearing [23]
Local antibiotic delivery independent of patient compliance [23]
Systemic toxicity of antibiotics very rarely observed [8]
Versatility of modifying antibiotic as per the culture report [27]
Control of infection and stability is achieved with a single procedure [44]
Alternative for patients refusing or not being right candidates for external fixation [13]

Local antibiotic carriers have never been shown to be superior to intravenous administration of antibiotics in terms of cure rate [21]
Require repeat surgery [23]
Possible emergence of resistance [13]
Possible MMA toxicity [102, 103]