What is the optimal perioperative antibiotic prophylaxis for patients undergoing spine surgery? What considerations should be made in cases of drug allergies?

What is the optimal perioperative antibiotic prophylaxis for patients undergoing spine surgery? What considerations should be made in cases of drug allergies?

Authors: Yvonne Achermann, John Koerner, Daniel Tarazona

RECOMMENDATION: The optimal prophylactic antibiotic for an uncomplicated spine surgery is a fi rst- or second-generation cephalosporin given intravenously within 60 minutes of initial incision. HAI: In patients with a history of anaphylactic reaction after use of beta lactams or in countries with a high rate of methicillin-resistant Staphylococcal infections, vancomycin in a weight-adjusted dose (15 mg/kg) should be used. Clindamycin 600 mg intravenously is an alternative to vancomycin.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 79%, Disagree: 7%, Abstain: 14% (Super Majority, Strong Consensus)

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