Acute tubular necrosis associated with high serum vancomycin and tobramycin levels after revision of total knee arthroplasty with antibiotic-containing calcium sulfate beads

Abstract

We present the case of a 59-year-old male who developed acute tubular necrosis with a serum tobramycin level of 15.9 mg/L after instillation of tobramycin and vancomycin calcium sulfate beads for infected total knee arthroplasty. We emphasize standardizing surgical protocols to mitigate nephrotoxicity based on current efficacy and safety data.