title: Should we add vancomycin antibiotic powder to prevent post operative infection in spine surgery?
abstract: Intravenous antibiotic prophylaxis is routinely administered to prevent surgical site infection in spinal surgery. Adding intrawound vancomycin powder before surgical closure might further decrease infection risk. However, its use is controversial. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews that considered 16 studies, including one randomized controlled trial. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded vancomycin probably does not decrease the risk of infection in low risk surgery, but there is uncertainty about its effects in populations or surgeries with a higher risk because the certainty of the evidence is very low.
authors.affiliation: Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos. Address: Facultad de Medicina Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile. Email: mmolinas@med.puc.cl.
authors.forename: Mario
authors.initials: M
authors.lastname: López
authors.affiliation: Departamento de traumatología y ortopedia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Molina
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods; D011208:Powders; D016032:Randomized Controlled Trials as Topic; D013131:Spine / Q000601:surgery; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D011208:Powders; D014640:Vancomycin