Dear Fadi

VERTEBROPLASTY AND KYPHOPLASTY

There are little data to support the routine use of PR-ABX for vertebroplasty or kyphoplasty procedures. There are only sporadic case reports of infection after vertebroplasty or kyphoplasty and, indeed, no infections were reported in a series of 1150 kyphoplasties after the administration of 1.5 g of cefuroxime.35 However, given the serious morbidity associated with bone or cement implant infection, most operators choose to use PR-ABX.

When infections do occur, the most common bacteria are skin organisms such as Staphylococci and Streptococci; therefore, 1 g cefazolin,22 1.5 g cefuroxime,35 or 600 mg clindamycin36 are recommended antibiotics. Also of note, some operators use antibiotic-impregnated cement in which 1.2 g of tobramycin is mixed with the polymethyl methacrylate (PMMA) cement. There are no reported advantages of intravenous antibiotics over antibiotic-impregnated cement, or vice versa.

source: 

Semin Intervent Radiol. 2010 Dec; 27(4): 327–337.

Pharmacology in Interventional Radiology

Guest EditorsKimi L. Kondo, D.O.Charles E. Ray, M.D.

Prophylactic Antibiotic Guidelines in Modern Interventional Radiology Practice

Eunice Moon, M.D.,1 Matthew D.B.S. Tam, B.M.B.Ch., M.R.C.S., F.R.C.R., M.A.(Oxon), M.Clin.Ed.,1 Raghid N. Kikano, M.D.,1 and Karunakaravel Karuppasamy, M.B.B.S., F.R.C.R.

As Nelson noted above,  perioperative prophylaxis is recommended (second generation cephalosprins). Otherwise, I do not find much sense in antibiotics application when antibiotic-impregnated cement is used. 

I don't use post kyphoplasty prophylactic antibiotics, but the cement is antibiotic-impregnated.

Recommendations are to use prophylactic antibiotics is risk of infection exceeds 1 or 2 per cent of patients undergoing the procedure.

To my knowledge, the No. of infections is (due to small incusions, small soft tissue damage and short operation time) significantly lower (maybe 1/1000???, no data known), given standard sterile techniques are followed.

Secondly some

I don't use  antibiotics kyphoplasty prophylactic. the sterile techniques before and after the procedure are important.