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European Spine Journal

, Volume 28, Issue 12, pp 2972–2980 | Cite as

Meta-analysis of topical vancomycin powder for microbial profile in spinal surgical site infections

  • Sipeng Li
  • Hongtao Rong
  • Xueqin Zhang
  • Zhengshan Zhang
  • Chao Wang
  • Rui Tan
  • Yi Wang
  • Ting Zheng
  • Tao ZhuEmail author
Review Article

Abstract

Objectives

To systematically evaluate the impact of topical vancomycin powder for microbial profile in spinal surgical site infections.

Methods

All available literature regarding the topical use of vancomycin powder to prevent postoperative spinal infections was retrieved from the MEDLINE, EMBASE, and Cochrane databases starting from the creation date and up until September 30, 2018.

Results

A total of 21 studies involving 15,548 patients were reviewed. The combined odds ratio showed that topical use of vancomycin powder was effective for reducing the incidence of gram-positive bacterial infections in spinal surgical sites (OR 0.41, P < 0.00001) without affecting its efficacy in the prevention of polymicrobial infections (OR 0.30, P = 0.03). Additionally, it could significantly reduce the infection rate of methicillin-resistant staphylococcus (OR 0.34, P < 0.0001). However, topical vancomycin powder showed no advantage for preventing gram-negative bacterial infections (OR 0.94, P = 0.75).

Conclusions

Topical administration of vancomycin powder may not increase the rates of gram-negative bacterial or polymicrobial infections in spinal surgical sites. On the contrary, it can significantly reduce the infection rates of gram-positive bacteria, methicillin-resistant staphylococcus (MRS) and microorganism. Of course, the topical vancomycin powder cannot change the rates of gram-negative bacterial infections, which may be related to the antimicrobial spectrum of vancomycin. Due to the limited number of articles included in this study, additional large-scale and high-quality studies are needed to provide more reliable clinical evidence.

Graphic abstract

Keywords

Vancomycin powder Spinal surgery Surgical site infections Microbial profile Meta-analysis 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest or funding sources in the article.

Supplementary material

586_2019_6143_MOESM1_ESM.pptx (134 kb)
Supplementary file1 (PPTX 134 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Sipeng Li
    • 1
  • Hongtao Rong
    • 1
  • Xueqin Zhang
    • 1
  • Zhengshan Zhang
    • 1
  • Chao Wang
    • 1
  • Rui Tan
    • 1
  • Yi Wang
    • 1
  • Ting Zheng
    • 2
  • Tao Zhu
    • 1
    Email author
  1. 1.Department of NeurosurgeryTianjin Medical University General HospitalTianjinChina
  2. 2.Tianjin Medical University General HospitalTianjinChina

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