Topical Antibiotic Treatment for Spine Surgical Site Infections

Surgical site infection (SSI) after spine surgery is a devastating complication. It is classified as a “never event” by payers, because it is presumed to be the result of a lapse in quality.

A mainstay of SSI prevention is antibiotic treatment, but antibiotic concentrations are lower in bone tissue than blood levels. Because of this, there has been increasing interest in the use of in-wound antibiotics (IWA) placed directly on the spine at the completion of surgery to help avoid spine SSI. However, because spine SSI happens relatively infrequently and there is considerable variation in IWA techniques among hospitals and surgeons, it remains to be determined if the broad use of IWA would actually decrease rates of spine SSI.

CERTAIN created the Spine Infection study to better understand surgeon practices and beliefs around in-wound antibiotics. The study partnered with spine surgery clinics and hospitals to:

  • Invite surgeons and staff to participate in research activities designed to characterize patterns of IWA use
  • Identify knowledge gaps around IWA
  • Design further research and implementation tools to support IWA adoption as appropriate  

The Spine Infection study has been completed as of September 2018 and is no longer enrolling participants.

Funded by: National Institute of Arthritis and Musculoskeletal and Skin Diseases