Efficacy and safety of locally-applied vancomycin powder injection for the prevention of prosthetic joint infection

Purpose: To determine the efficacy and safety of locally-applied vancomycin powder injection as precaution against prosthetic joint infection (PJI).Methods: A total of ninety subjects on admission in Department of Limb and Joint Surgery, PLA Medical Center, who underwent surgery for arthroplasty of knee and hip, were selected for this study. They were divided into two groups comprising control group (n = 45) given routine preventive antibiotic therapy as well as treatment group (n = 45) which received routine prophylactic antibiotics in combination with vancomycin therapy. PJI and the incidence of adverse reactions within 3 months after surgery were recorded. Body temperature of the patients was recorded with a thermometer. The number of neutrophils was measured by flow cytometry, while the expression levels of IL-6 and hs-CRP in peripheral blood were determined using enzyme-linked immunosorbent assay (ELISA) preoperatively and at 24, 72 and 168 h post-therapy.Results: At 90 days post-therapy, there was obviously significant reduction in the degree of PJI in the vancomycin-treated subjects compared with control group (p > 0.05). Moreover, within 3 days, normothermia, lowered neutrophil population and downregulated expressions of Il-6 and hs-CRP were seen in the vancomycin group, when compared to control subjects (p < 0.05). However, there was no significant difference in the incidence of adverse reactions between the treatment and control groups after therapy (p > 0.05). Conclusion: Topical application of vancomycin powder injection is safe, and regulates the body temperature of PJI patients in the short-term after surgery. Moreover, it decreases the levels of inflammatory indices. However, further clinical trials should be carried out prior to application in clinical practice.