Prospective randomized clinical trial of single dose intravenous cefazolin vs topical vancomycin in non-instrumented spine surgery
Authors : Dr. Dheeraj Kumar, Dr. Kenny Samuel David, Dr. Vijay Kamath, Dr. K. Venkatesh
Authors Affiliations: C.M.C. Vellore
Address of correspondence: Dr. Dheeraj Kumar, 19-10-647, “Sundari”, B.R. Karkera Road, Pandeshwar, Mangalore, Karnataka – 575001
This study was conducted to assess the efficacy of intraoperative topical vancomycin as an agent of perioperative prophylaxis in noninstumented spine surgery and to compare its efficacy with single dose intravenous cefazolin. It was conducted as a prospective randomised control trial at Christian Medical College Vellore, on 420 subjects undergoing primary lumbar discectomy and decompression without instrumentation. Subjects who gave consent, were randomly distributed into 2 cohorts. One cohort received peri-operartive intravenous cefazolin and the other received intra operative, intra- wound vancomycin powder. The primary outcome was the incidence of deep infection (within deep fascia). Surgical Site Infection (SSI) was defined as being diagnosed during the initial hospitalization or during hospitalization or on post operative hospital out-patient follow up. Differences between the two groups were assessed with Students T test.
In those patients suspected to have a deep SSI total and differential count, C-reactive protein and culture swabs were evaluated to confirm presence of peri-operative infection.
The follow up period varied between 4 weeks to 16 months. No patients were lost to follow up.
The results revealed a total of 15 patients were diagnosed to have deep SSI. Amongst the subjects with SSI, 12 received intravenous cefazolin 3 received vancomycin. The statistics revealed no significant difference between the 2 antibiotic groups, nor with regard to superficial and deep infection. It was concluded, from the current study showed no significant differences between intravenous cefazolin & topical vancomycin.
There were no differences in the rates of infection with the use of single dose of antibiotic administered in the perioperative period as compared to the standard post operative prophylaxis.
|How to Cite this Abstract|
|Kumar D. Prospective randomized clinical trial of single dose intravenous cefazolin vs topical vancomycin in non-instrumented spine surgery. International Journal of Conference Proceedings. March 2015;(2015):18.|