Vancomycin prophylaxis and elective total joint arthroplasty

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AU: Ritter-MA; Barzilauskas-CD; Faris-PM; Keating-EM SO: Orthopedics. 1989 Oct; 12(10): 1333-6 AB: A series of 201 consecutive patients treated with unilateral or bilateral total joint arthroplasty were given a single-dose prophylactic antibiotic regimen consisting of 1 g vancomycin infused over 1 hour on the morning of surgery and 80 g gentamicin given upon arrival in the operating room. Bactericidal blood levels were maintained during and for 24 hours after surgery. Elevated serum creatinine levels developed postsurgically in 8 patients but returned to normal. No serious hypersensitivity reactions occurred; minor reactions responded to antihistamine therapy. No postoperative infections were reported. Cost of administration compared favorably with 24- and 48-hour regimens employing cephalosporins. The investigators concluded that a combined single dose vancomycin/gentamicin regimen is a safe, effective, and cost efficient method of orthopedic implant prophylaxis.