Articles | Volume 8, issue 6
Original full-length article
30 Oct 2023
Original full-length article |  | 30 Oct 2023

Antimicrobial prophylaxis with teicoplanin plus gentamicin in primary total joint arthroplasty

Tariq Azamgarhi, Craig Gerrand, John A. Skinner, Alexander Sell, Robert A. McCulloch, and Simon Warren

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Cited articles

Asín-Prieto, E., Soraluce, A., Trocóniz, I. F., Campo Cimarras, E., Sáenz De Ugarte Sobrón, J., Rodríguez-Gascón, A., and Isla, A.: Population pharmacokinetic models for cefuroxime and metronidazole used in combination as prophylactic agents in colorectal surgery: Model-based evaluation of standard dosing regimens, Int. J. Antimicrob. Ag., 45, 504–511,, 2015. 
Aujla, R. S., Bryson, D. J., Gulihar, A., and Taylor, G. J.: Trends in orthopaedic antimicrobial prophylaxis in the UK between 2005 and 2011, An. Roy. Coll. Surg., 95, 495–502,, 2013. 
Azamgarhi, T., Shah, A., and Warren, S.: Teicoplanin anaphylaxis associated with surgical prophylaxis, Brit. J. Clin. Pharmaco., 84, 1038–1044,, 2018. 
Bell, S., Davey, P., Nathwani, D., Marwick, C., Vadiveloo, T., Sneddon, J., Patton, A., Bennie, M., Fleming, S., and Donnan, P. T.: Risk of AKI with gentamicin as surgical prophylaxis, J. Am. Soc. Nephrol., 25, 2625–2632,, 2014. 
Branch-Elliman, W., Ripollone, J. E., O'Brien, W. J., Itani, K. M. F., Schweizer, M. L., Perencevich, E., Strymish, J., and Gupta, K.: Risk of surgical site infection, acute kidney injury, and Clostridium difficile infection following antibiotic prophylaxis with vancomycin plus a beta-lactam versus either drug alone: A national propensity-score-adjusted retrospective cohort study, PLoS Med., 14, e1002340,, 2017. 
Short summary
We compared prosthetic joint infection (PJI) and acute kidney injury (AKI) rates among cohorts before and after changing our hospital's antimicrobial prophylaxis from cefuroxime to teicoplanin plus gentamicin for primary total joint arthroplasty. Switching to teicoplanin and gentamicin was associated with a significant risk reduction for PJI of 75.2 %. Significantly higher AKI rates were seen in patients receiving teicoplanin plus gentamicin; however, these were mild (KDIGO stage 1).