The key factors in setting the local concentration of antibacterial agents are 'resistant bacteria' and 'biofilms'.

It takes several to several tens of times the MIC (minimal inhibitory concentration) to suppress resistant bacteriaMPC(mutant prevention concentration) is required. MSW(Mutant Selection Window) is defined between MIC and MPC,  susceptible bacteria are killed and only resistant bacteria are allowed to survive. Intravenous administration deliver the antibiotics in this range of MSW and it is not recommended as long-term administration may induce resistant strains.

Moreover, 100 to 1000 MICs are required to suppress the biofilm, which isMBEC(minimal biofilm eradication concentration). In general, tissue with biofilm formation has no choice but to remove the implant, and it is recommended for aggressive debridement the tissue in the infected wound.

However, by increasing the concentration of antibacterial drugs locally transferred by CLAP to exceed MPC and MBEC, resistant bacteria can be suppressed without inducing resistant bacteria. Biofilms can also be suppressed at higher concentration. By using CLAP, it may be possible to control the infection by preserving the implant while preserving the tissue without radical debridement. Even if the infection has not completely subsided, it is possible to fix the bone by ORIF, or to remove the loose implant and one-stage exchange the implant. In this way, it becomes possible to take strategies that could not be considered in conventional treatments.