Prosthetic joint infection

Vancomycin IV (dosing info here)

and

Gentamicin IV (dosing info here)

If possible, obtain blood cultures, joint aspirates and, where possible, bone biopsies before starting treatment. 

A cell count and gram stain can only be performed on a joint aspirate sent in a sterile universal container.

Review gentamicin at 72 hours as per 'IV Gentamicin Review after 72 hours of Treatment' algorithm (N.B. links within the document are only active if accessing via NHS network).

Patients with acute or chronic impairment of renal function and an eGFR <20ml/min and those with decompensated alcoholic liver disease are at increased risk of adverse events with gentamicin. IV temocillin (see here for dosing guidance) is a beta-lactam antimicrobial with a comparable breadth of gram negative cover which can replace gentamicin in these patient populations, provided they do not have a history of penicillin allergy.