Antibiotic Prophylaxis in Instrumented Lumbar Spine Surgery: Cefazolin Outperforms Clindamycin Regardless of Duration
Abstract
1. Introduction
2. Results
2.1. Patients Data and Characteristics
2.2. Antibiotic Prophylaxis Regimens and the Prevalence of SSIs
2.3. Effect of Single Dose Antibiotic Prophylaxis—1 g Cefazolin, 2 g Cefazolin, and 0.6 g Clindamycin—On Rate of SSIs
2.4. Effect of Single Dose Versus 72 h Antibiotic Prophylaxis on SSI Occurance Between 2023 and 2024
3. Discussion
4. Patients and Methods
4.1. Patients Selection
4.2. Antibiotic Prophylaxis Protocols
4.3. SSI Definition, Variables Analyzed, and Exclusions
4.4. Statistic Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
BMI | body mass index |
DM | diabetes mellitus |
MISS | minimal invasive spine surgery |
N/A | not available |
OR | odds ratio |
qu | quartile |
SD | standard deviation |
SSI | surgical site infection |
References
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Characteristics of the Patients | Non-Infected Cases (807) | SSI Cases (107) | p-Value |
---|---|---|---|
Age (years), mean (SD 1) | 63.4 (12.2) | 65.5 (11.6) | 0.0890 (Welch) |
min; 1st qu. 2; median; 3rd qu.; max | 14.2; 56.6; 65.7; 72.3; 87.6 | 21.5; 60.6; 67.5; 73.6; 83.6 | |
Male (%) | 330 (40.9%) | 36 (33.6%) | 0.1724 (Fisher) |
Diabetes mellitus (%) | 169 (21.0%) (N/A 3 = 1) | 28 (26.2%) | 0.2136 (Fisher) |
BMI 4, mean (SD) min; 1st qu.; median; 3rd qu.; max | 29.1 (5.1) (N/A = 5) 16.7; 25.5; 28.9; 32.4; 48.3 | 30.9 (6.4) 17.6; 26.7; 30.5; 34.3; 58.2 | 0.0081 (Welch) |
MISS 5 (%) | 160 (19.8%) | 16 (15.0%) | 0.2959 (Fisher) |
Segments (%) | (N/A = 1) | 0.0005 (Fisher) | |
1–2 | 698 (86.6%) | 71 (66.4%) | |
3–7 | 106 (13.2%) | 36 (33.6%) | |
≥8 | 2 (0.2%) | 0 (0%) | |
SSIs 6 (%) | |||
Superficial SSIs | N/A | 30 (28.0%) | |
Deep SSIs | N/A | 36 (33.6%) | |
Organ SSIs | N/A | 41 (38.3%) |
Antibiotics | Dosage | Duration | Time Interval |
---|---|---|---|
Cefazolin | 1 g | Single dose | 2016–2024 |
Cefazolin | 1 g | 72 h | 2023–2024 |
Cefazolin | 2 g | Single dose | 2016–2024 |
Cefazolin | 2 g | 72 h | 2023–2024 |
Clindamycin | 0.6 g | Single dose | 2016–2024 |
Clindamycin | 0.6 g | 72 h | 2023–2024 |
SSIs | Total n = 253 | Single Dose Antibiotic n = 227 | 72 h Antibiotic n = 26 |
---|---|---|---|
None | 230 | 205 | 25 |
Cefazolin 1 g = 90 | Cefazolin 1 g = 6 | ||
Cefazolin 2 g = 106 | Cefazolin 2 g = 15 | ||
Clindamycin 0.6 g = 9 | Clindamycin 0.6 g = 4 | ||
Superficial | 2 | 2 | 0 |
Cefazolin 1 g = 2 | |||
Deep | 11 | 10 | 1 |
Cefazolin 1 g = 4 | Cefazolin 1 g | ||
Cefazolin 2 g = 6 | |||
Organ | 10 | 10 | 0 |
Cefazolin 1 g = 4 | |||
Cefazolin 2 g = 3 | |||
Clindamycin 0.6 g = 3 |
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Nagy, Z.; Szabó, D.; Agócs, G.; Szilágyi, K.; Rojcsik, Z.; Budai, J.; Papp, Z.; Padányi, C.; Erőss, L.; Sipos, L.; et al. Antibiotic Prophylaxis in Instrumented Lumbar Spine Surgery: Cefazolin Outperforms Clindamycin Regardless of Duration. Antibiotics 2025, 14, 830. https://doi.org/10.3390/antibiotics14080830
Nagy Z, Szabó D, Agócs G, Szilágyi K, Rojcsik Z, Budai J, Papp Z, Padányi C, Erőss L, Sipos L, et al. Antibiotic Prophylaxis in Instrumented Lumbar Spine Surgery: Cefazolin Outperforms Clindamycin Regardless of Duration. Antibiotics. 2025; 14(8):830. https://doi.org/10.3390/antibiotics14080830
Chicago/Turabian StyleNagy, Zoltán, Dóra Szabó, Gergely Agócs, Konrád Szilágyi, Zsanett Rojcsik, József Budai, Zoltán Papp, Csaba Padányi, Loránd Erőss, László Sipos, and et al. 2025. "Antibiotic Prophylaxis in Instrumented Lumbar Spine Surgery: Cefazolin Outperforms Clindamycin Regardless of Duration" Antibiotics 14, no. 8: 830. https://doi.org/10.3390/antibiotics14080830
APA StyleNagy, Z., Szabó, D., Agócs, G., Szilágyi, K., Rojcsik, Z., Budai, J., Papp, Z., Padányi, C., Erőss, L., Sipos, L., & Banczerowski, P. (2025). Antibiotic Prophylaxis in Instrumented Lumbar Spine Surgery: Cefazolin Outperforms Clindamycin Regardless of Duration. Antibiotics, 14(8), 830. https://doi.org/10.3390/antibiotics14080830