Local Vancomycin Usage for Prophylaxis of Surgical Site Infections

Surgical site infections (SSI) are one of the major causes of hospital-acquired infections. Despite not recommended in the guidelines, powdered antibiotics are frequently applied locally. The aim of this application is to obtain more and longer antibiotic concentrations in the surgical site than systemic circulation. Less systemic exposure is expected to result in less undesirable effects. However, there is no high-quality clinical evidence supporting this practice in the literature. The role of the antibiotics applied as local powders and the appropriate timing of these antibiotics are not clear. In addition, the process of both preparation and administration of these antibiotics is not defined, so such practices carry concerns and risks. In this article, it was aimed to summarize the current clinical evidence related to the local use of vancomycin for the prevention of SSI and to present the advantages and disadvantages of this usage.