Management
A single dose of 1 g vancomycin infused over 1 hour and 80 g gentamicin provided effective prophylaxis in 201 patients undergoing unilateral or bilateral total joint arthroplasty, maintaining bactericidal blood levels for 24 hours post-surgery without reported postoperative infections [PMID:2798242].
Complications
Elevated serum creatinine levels were observed in 8 patients post-surgery but returned to normal without long-term complications [PMID:2798242].
Key Recommendations
The single-dose vancomycin/gentamicin regimen was found to be cost-effective compared to 24- and 48-hour cephalosporin prophylaxis regimens [PMID:2798242]. (Evidence: Moderate)
References
1 Ritter MA, Barzilauskas CD, Faris PM, Keating EM. Vancomycin prophylaxis and elective total joint arthroplasty. Orthopedics 1989. link
1 papers cited of 3 indexed.