A Meta-analysis of the efficacy of topical antibiotics in spinal surgery for the prevention of surgical site infection

Background Despite significant advancements in clinical aseptic techniques and wound infection control, surgical site infections (SSIs) continue to pose a significant risk and complication following spinal surgery. The use of intrawound antibiotics for the prevention of SSIs after spine surgery is a controversial method. Objective To conduct a review of the current literature on the use of antibiotics in wound care and evaluate their effectiveness in preventing postoperative SSIs. Methods Keywords such as “spinal surgery” or “spine”, “antibiotics”, “local” or “topical”, “prevention of infection”, and “infection” were used based on PubMed, Web of Science, Cochrane and Embase database. The literature was screened based on the title, abstract, full text reading, and extraction of relevant research data. Comparisons of the data were performed using RevMan 5.3 software. Results A total of 18922 patients from 24 studies were included in the final analysis, 8878 patients received antibiotics (experimental group) to prevent SSIs, and 10044 patients did not receive any additional antibiotics (control group). In the experimental group, 178 patients developed SSIs, compared to 356 patients in the control group. The results of the meta-analysis indicated that the incidence of SSIs in the experimental group was significant lower than that in the control group (95% confidence interval, 0.36-0.75, p=0.0004). Conclusion The topical application of antibiotics within the wound site is a crucial and efficient method to prevent SSIs after spinal surgery.