Antibiotic-loaded bone cement (ALBC) spacers are the mainstay in 2-stage revision, but antibiotics (vancomycin plus aminoglycosides) may undergo systemic absorption, resulting in acute kidney injury (AKI). Data on spacer antibiotics are heterogeneous. Our objective was to review risk factors for AKI and dosage of antibiotics. Significant AKI risk factors were antibiotic concentration greater than 3 or 3.6 g per cement batch, comorbidities, chronic kidney disease, and hypovolemia. Despite similar spacer antibiotic dosing, there was remarkable variability in serum concentrations. To err on the side of caution, it appears that antibiotic dose below 3 g per cement batch might be relatively safe until more evidence surfaces. Consideration of risk factors for AKI calls for appropriate antibiotic use in 2-stage revision. [Orthopedics. 20XX;XX(X):xx–xx.]

载有抗生素的骨水泥 (ALBC) 间隔物是二期翻修的主要支柱，但抗生素（万古霉素加氨基糖苷类）可能会发生全身吸收，导致急性肾损伤 (AKI)。关于间隔抗生素的数据是异质的。我们的目标是审查 AKI 的危险因素和抗生素的剂量。显着的 AKI 危险因素是抗生素浓度大于 3 或 3.6 g/水泥批次、合并症、慢性肾病和低血容量。尽管间隔抗生素剂量相似，但血清浓度存在显着差异。为谨慎起见，在更多证据浮出水面之前，每批骨水泥的抗生素剂量低于 3 克似乎是相对安全的。考虑到 AKI 的危险因素，要求在 2 期翻修中适当使用抗生素。[骨科。20XX;XX(X):xx–xx.]