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**NEXCHANGE KIT** is an investigational, fixed-combination drug-device product from Osteal Therapeutics for treatment of hip or knee periprosthetic joint infection during two-stage exchange arthroplasty. The kit uses a spacer, wound-fluid management components, and an irrigation system to cyclically administer high local concentrations of **vancomycin** and **tobramycin** into the infected joint space over approximately seven days before permanent-prosthesis reimplantation. Vancomycin inhibits bacterial cell-wall synthesis by binding peptidoglycan precursor termini, while tobramycin binds bacterial 30S ribosomes and disrupts protein synthesis. NEXCHANGE KIT remains investigational and is not FDA approved. ([ostealtx.com](https://www.ostealtx.com/nexchange))
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