Vancomycin prophylaxis and elective total joint arthroplasty.
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.
Ritter
M A
MA
Louisiana State University Medical Center, Shreveport.
Barzilauskas
C D
CD
Faris
P M
PM
Keating
E M
EM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty; D004359:Drug Therapy, Combination; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011292:Premedication / Q000191:economics / Q000592:standards*; D011446:Prospective Studies; D014640:Vancomycin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*
D005839:Gentamicins; D014640:Vancomycin