The efficiency of vancomycin powder and rifampicin for deep surgical site infections in spinal instrumentation surgery

Objective: Infection after spinal surgery always increases the hospital stay in the clinic and can cause serious patient morbidity. This study aimed to show the difference between sprinkling vancomycin powder and washing with rifampicin during debridement surgery in deep infections seen after spinal instrumentation surgeries. Material and methods: This present study was conducted on 179 cases of infection after spinal instrumentation surgeries. The patients were divided into three groups: those receiving topical vancomycin, rifampicin irrigation, and only normal saline irrigation. The preoperative and postoperative CRP levels, hospitalization time, operation length, bone involvement, second operation for infection, impact removal surgeries, and mortality rates have been examined. Results: The CRP decrease on the 5th day was faster in the rifampicin group (p<0.001). On the 30th day, vancomycin and rifampicin decreased CRP values and had a similar effect on hospitalization time but were more effective than the normal saline group (p<0.001). In patients with bone involvement, the rifampicin group was superior to vancomycin and reduced implant removal surgery (p<0.001). Conclusions: Vancomycin powder and rifampicin application during debridement in deep spinal surgical site infections can reduce hospital stays and prevent secondary surgeries. In addition, rifampicin can be effective in infections with bone involvement