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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