Loading
Surgical Site Infection Prevention / Orthopedic Infections and Treatments · Journal article
Journal of Orthopaedic Surgery and Research · August 20, 2026
Encouraging direction, but not yet definitive.
In this single-centre retrospective series, 274 PVP patients carefully screened for absent active infection (fever, infection focus, normal procalcitonin) by multidisciplinary review omitted antimicrobial prophylaxis and experienced zero surgical site infections over 90 days (95% CI 0–1.35%). The result suggests that active infection exclusion may be a safe alternative to blanket prophylaxis in high-risk patients, but lacks a comparator arm and multi-centre validation.
Retrospective cohort study. Patients undergoing percutaneous vertebroplasty at a tertiary hospital who did not receive preoperative antimicrobial prophylaxis and had at least 90 days of follow-up. Eligibility required confirmation of absent active infection by multidisciplinary review.. Intervention: Omission of preoperative antimicrobial prophylaxis in PVP patients, following MDT evaluation confirming absence of active infection. n = 274. Single tertiary hospital (location not specified in abstract).
90-day SSI rate was 0% (0 of 274 patients) with 95% CI 0–1.35% 37.6% (103/274) were aged ≥75 years; 12.8% (35/274) had diabetes; 7.7% (21/274) had malignancy Prophylaxis omission rate rose from 52.2% (117/224) in 2024 to 66.3% (136/205) in 2025 to 87.5% (21/24) by January 2026
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
If confirmed, this suggests that active infection exclusion via multidisciplinary review may allow safe omission of routine antimicrobial prophylaxis in PVP even for high-risk patients, potentially reducing unnecessary antibiotic exposure. However, this is a single observational cohort without a control group; broader validation and comparison with standard prophylaxis practice are needed before changing clinical policy.
A real-world retrospective cohort of 274 PVP patients omitting prophylaxis showed zero SSI at 90 days, but the absence of a comparator arm and single-centre design limit definitive inference about safety policy.
As stated by the source record.
Quoted from the source exactly as published.
If confirmed, this suggests that active infection exclusion via multidisciplinary review may allow safe omission of routine antimicrobial prophylaxis in PVP even for high-risk patients, potentially reducing unnecessary antibiotic exposure. However, this is a single observational cohort without a control group; broader validation and comparison with standard prophylaxis practice are needed before changing clinical policy.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background Surgical site infections (SSIs) following percutaneous vertebroplasty (PVP) are infrequent but can have serious consequences. Current guidelines suggest that antimicrobial prophylaxis “may be considered” for high-risk patients undergoing PVP due to the implantation of bone cement. However, in practice, this conditional recommendation is often misinterpreted as a requirement, resulting in unnecessary antibiotic use. This study aimed to assess the safety of omitting antimicrobial prophylaxis in high-risk PVP patients. Methods We conducted a retrospective analysis of data from patients who underwent PVP at a tertiary hospital between January 2024 and January 2026. These patients did not receive preoperative antimicrobial prophylaxis and had at least 90 days of follow-up. The decision to omit prophylaxis was made by a clinical pharmacist during a preoperative multidisciplinary team (MDT) evaluation. This decision was based on the absence of active infection, indicated by no fever, no identifiable infectious focus, and normal procalcitonin levels when measured. The primary outcome was a 90-day SSI, defined by US CDC criteria, which includes a 90-day surveillance window for procedures involving implant placement. Postoperative follow-up was conducted via telephone, and patients were instructed to return immediately if they experienced wound redness, purulent discharge, fever, or any other signs of infection. Results The percentage of PVP procedures performed without antimicrobial prophylaxis rose from 52.2% (117/224) in 2024 to 66.3% (136/205) in 2025, and further increased to 87.5% (21/24) by January 2026. Throughout the study period (January 2024–January 2026), 274 PVP patients did not receive preoperative antimicrobial prophylaxis. Of these patients, 103 (37.6%) were aged 75 or older, 35 (12.8%) had diabetes mellitus, 21 (7.7%) had malignancy, 79 (28.8%) had chronic pulmonary disease, and 2 (0.7%) had hypoalbuminaemia. Three patients had both diabetes and malignancy. All 274 patients completed a 90-day follow-up, and none developed a surgical site infection. The 90-day SSI rate was 0% (95% CI 0–1.35%). Conclusions Once active infection is definitively ruled out, antimicrobial prophylaxis can be safely omitted, even for patients with conventional risk factors like advanced age, diabetes, and malignancy. A multidisciplinary team (MDT) approach, led by pharmacists and centered on confirming the absence of active infection, offers a safe and practical strategy for managing perioperative antimicrobial use.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.