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Applied intraoperatively during primary arthroplasty or prosthetic joint exchange, this drug\u2010delivery vehicle has become a popular means of maximizing drug concentrations within a joint space while minimizing systemic exposure. Antimicrobial characteristics conducive to cement loading include availability of a crystalline powder formulation, molecular characteristics, minimal impact on cement integrity, and other variables promoting drug elution. Antimicrobials most commonly incorporated into cements are vancomycin and aminoglycosides, usually in combination due to synergistic antibacterial activity and enhanced cement elution. Other classes include the \u03b2\u2010lactams, lipopeptides, oxazolidinones, and antifungals. With the exception of several commercially available <jats:styled-content style=\"fixed-case\">AIBC<\/jats:styled-content>s, most products are compounded extemporaneously without a formal safety or efficacy assessment. Few randomized controlled trials have been conducted to assess the benefit or optimal use of these cement preparations, and variable methodology renders cross\u2010study comparison challenging. Given the lack of standardization and multidisciplinary oversight often seen with practical <jats:styled-content style=\"fixed-case\">AIBC<\/jats:styled-content> use, additional data are needed. This review presents information intended to guide <jats:styled-content style=\"fixed-case\">AIBC<\/jats:styled-content> preparation, selection, dosing, and safe use. 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