Does Vancomycin as the First-Choice Therapy for Antibiotic Prophylaxis Increase the Risk of Surgical Site Infections Following Spine Surgery?

ABSTRACT: Surgical site infections (SSIs) remain a significant complication in spine surgery, especially in instrumented procedures with long operative times. Although guidelines recommend cefazolin as the first-line agent due to its efficacy against Staphylococcus aureus, predictable pharmacokinetics, and safety, its real-world practice is highly variable, with inappropriate and prolonged regimens reported across Europe. Vancomycin is often used as the first choice of therapy empirically and without screening, exposing patients to risks such as delayed infusion, nephrotoxicity, and the emergence of vancomycin-resistant enterococci (VRE).This review assesses the present function of vancomycin in relation to cefazolin for spinal prophylaxis and examines wider trends in the misuse of surgical antibiot

SUBMITTER: Bogosavljevic V 

PROVIDER: S-EPMC12561592 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature