Is the routine use of systemic antibiotics after spine surgery warranted? A systematic review and meta-analysis

Effects of extended oral antibiotic prophylaxis on surgical site infections after instrumented spinal fusion: a cohort study of 901 patients with a minimum follow-up of 1 year

“…Another strength of our study is the large size of the sample analyzed, although, without a previous sample size calculation, 901 patients are a sufficient sample to detect a reduction, between comparable groups, of approximately 4% (from 6.2% to 1.7%) in the incidence of SSI. Nevertheless, as our results are contrary to the latest published evidence ( 22 ), it is paramount to consider the study’s potential limitations.…”

Antibiotic use in spine surgery: A narrative review based in principles of antibiotic stewardship

“…The authors reported no significant difference in infection risk, rate of drug resistant infections, or Clostridium difficile infections between groups [29] . Further, 2 systematic reviews determined that there was no significant decrease in occurrence of SSIs when administering antibiotic prophylaxis postoperatively, specifically in trauma patients, instrumented and noninstrumented lumbar spine surgery, and in patients with drain placement with insufficient evidence regarding other types of spine surgeries [30 , 31] . The NASS guidelines reported insufficient evidence regarding discontinuation of antibiotics after 24 hours in patients with drain placement [8] .…”

Research

“…In this systematic review from Phoenix (Arizona, USA) , the authors aimed to investigate the evidence for routine postoperative antibiotics in spine surgery. 6 They undertook a well conducted systematic review and meta-analysis in order to see what the evidence base is for such prophylactic antibiotic use. Following an extensive literature search, the review team identified 13 suitable studies which were included in the analysis, representing between them 10,333 patients.…”