A study recently published in Spine examined the cost effectiveness of using vancomycin in thoracolumbar adult deformity surgeries to curb infections.
The researchers examined 215 adults who underwent deformity reconstruction performed by two surgeons between 2008 and 2012. The minimum follow-up was three months. There were 115 patients who underwent spinal surgery with vancomycin powder and 64 who underwent surgery without vancomycin powder. The patients who had vancomycin powder received intravenous antibiotics and two grams of vancomycin powder applied to the surgical wound. The control group only received routine preoperative intravenous antibiotics.
There were around 10 levels fused in the control group and 12 levels fused on in the vancomycin group on average. The average follow-up was 34 months for the control group and 18 months for the vancomycin group. The researchers found:
1. There were significantly fewer 90-day hospital readmissions for surgical site infection patients who received vancomycin powder. The percentage of patients who were readmitted for SSI within 90 days is:
• Vancomycin group: 2.6 percent
• Routine antibiotic group: 10.9 percent
2. No adverse events were reported related to intrawound vancomycin use.
3. Costs per patient treated with postoperative SSI varied between both groups:
• Vancomycin group: $28,169
• Control group: $34,388
4. There was a cost savings of $244,402 per 100 complex spinal procedures with the use of vancomycin powder.
5. A separate study published in The Spine Journal in March shows patients who received vancomycin at $12 per dose were less likely to return for surgical site infection. A total of $1,152 was spent on vancomycin for 96 patients in the study. The average cost per episode of surgery was $40,992.
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