Data from a study published online in the journal Clinical Orthopaedics and Related Research suggest that many patients may not be adequately dosed with vancomycin prophylaxis prior to total joint arthroplasty (TJA). 

The research team notes that patients are often given a fixed 1 gram dose instead of the recommended dosing of 15 mg/kg. The authors conducted a retrospective study of 7,638 primary TJA patients at a single center, 1,828 of whom resceived vancomycin prophylaxis and 5,810 of whom received cefazolin monotherapy. They found that 2 percent (n = 32) of patients receiving vancomycin experienced periprosthetic joint infection (PJI), compared to 1 percent (n = 62) of cefazolin patients. Overall, 94 percent (1,726 of 1,828) of patients received a fixed 1 g dose of vancomycin, of whom 64 percent (1,105 of 1,726) were considered underdosed. No patients with adequate dosing or overdosing of vancomycin developed PJI with methicillin-resistant Staphylococcus aureus. Learn more...