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).

Patients undergoing multiple hip and knee revision arthroplasty procedures for periprosthetic joint infection can have a changing microbiological picture, which can impact their management and outcomes. We aimed to investigate this using data from two large-volume orthopaedic centres. A total of 106 patients were identified; after six revision procedures, 90 % of patients had different organisms cultured compared with the initial revision and 53 % of the organisms were multidrug resistant.