vancomycin + cefazolin + gentamicin

This is a compounded triple antibiotic irrigation solution (TAIS) consisting of vancomycin, cefazolin, and gentamicin, specifically utilized for the prevention of surgical site infections (SSI) in implant-based breast reconstruction. The combination provides broad-spectrum antimicrobial coverage by utilizing three distinct mechanisms of action: vancomycin targets resistant Gram-positive bacteria (including MRSA) by binding to the D-Ala-D-Ala terminus of peptidoglycan precursors; cefazolin, a first-generation cephalosporin, inhibits penicillin-binding proteins to disrupt bacterial cell wall synthesis; and gentamicin, an aminoglycoside, binds to the bacterial 30S ribosomal subunit to inhibit protein synthesis in Gram-negative bacteria. This formulation gained prominence as a preferred alternative to bacitracin-containing solutions following the FDA's 2020 decision to request the withdrawal of all injectable bacitracin products from the market due to toxicity concerns. It is typically administered as a local irrigation of the tissue pocket and the implant itself during reconstructive surgery.

Other names

Triple antibiotic irrigation solutionTAISTriple antibiotic solutionVancomycin-Cefazolin-Gentamicin irrigation