Should we add vancomycin antibiotic powder to prevent post operative infection in spine surgery? - First update.
This Living FRISBEE (Living FRIendly Summary of the Body of Evidence using Epistemonikos) is an update of the summary published in June 2015, based on the detection of a new systematic review not identified in the previous version. 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 seven 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.
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.
Mario
M
López
Departamento de traumatología y ortopedia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos.
Marcelo
M
Molina
D061605:Administration, Intravenous; 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*
D000900:Anti-Bacterial Agents; D011208:Powders; D014640:Vancomycin