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The antibiotic regimen associated with The London Spine Centre's PARISS (Prolonged Antibiotics in Spine Surgery) trial consists of either cefazolin or vancomycin administered for postoperative infection prophylaxis. Cefazolin is a first-generation cephalosporin that acts by inhibiting bacterial cell wall synthesis through the binding and inactivation of penicillin-binding proteins (PBPs). Vancomycin is a glycopeptide antibiotic that inhibits cell wall synthesis by binding to the D-alanyl-D-alanine C-terminus of peptidoglycan precursors, thereby blocking the polymerization of the bacterial cell wall. The Phase 4 trial specifically evaluates the efficacy of a standard 24-hour postoperative antibiotic course versus a prolonged 72-hour course (or until 24 hours after drain removal) in reducing the incidence of complicated surgical site infections in patients undergoing posterior spine surgery requiring Hemovac drains.
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