Prophylactic gentamicin and flucloxacillin is associated with increased rates of acute kidney injury in orthopaedic surgery

Introduction and Aims: Rising rates of Clostridium difficile infection (CDI), including fatal cases, prompted a number of measures to be implemented in 2008 in Scottish hospitals aimed at reducing CDI. These measures included restricting the use of broad spectrum antibiotics. Within the Tayside region of Scotland, the antibiotic policy was changed from cefuroxime to flucloxacillin and gentamicin as prophylaxis in patients undergoing orthopaedic surgery. A recent small observational study carried out in Dumfries and Galloway has raised concerns that this change has led to increased rates of AKI. The aim of this study was to examine the rates of AKI before and after the antibiotic policy change in patients undergoing orthopaedic surgery.