{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:26:11Z","timestamp":1787203571909,"version":"build-2736575974"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e0 degli Studi di Modena e Reggio Emilia"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      Postoperative spinal implant infections (PSIIs) are serious complications in spinal deformity surgery, with\n                      <jats:italic>Cutibacterium acnes<\/jats:italic>\n                      representing a frequent pathogen. This study aimed to evaluate whether adding of preoperative topical benzoyl peroxide (BPO) 5% to standard antibiotic prophylaxis could reduce early\n                      <jats:italic>C. acnes<\/jats:italic>\n                      \u2013related and overall PSIIs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective quasi-experimental study was performed at a tertiary spinal surgery center, including two sequential 12-month cohorts of patients undergoing corrective spinal surgery. The control group received standard intravenous antibiotic prophylaxis, while the intervention group received additional topical BPO 5% applied twice daily for three days before surgery. The primary outcome was the incidence of early\n                      <jats:italic>C. acnes<\/jats:italic>\n                      PSIIs within 90 days; the secondary outcome was the incidence of overall early PSIIs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 160 patients were analyzed (80 per group). Baseline demographic and surgical characteristics were comparable. Early PSIIs occurred in 12 patients (7.5% overall). The incidence was significantly lower in the BPO group compared with the standard care group (2.5% vs. 12.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036).\n                      <jats:italic>C. acnes-<\/jats:italic>\n                      related PSIIs occurred in one patient (1.3%) in the BPO group and six patients (7.5%) in the control group, representing a numerical reduction that did not reach statistical significance (HR:0.182[95%CI:0.022;1.52]). Cox regression showed lower hazard of overall infection in the BPO group compared with the SoC group (HR:0.21[95%CI:0.046;0.960]), although based on a small number of infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Preoperative application of BPO 5%, in combination with standard antibiotic prophylaxis, was associated with a significant reduction in overall early PSIIs and with a clinically meaningful but statistically non-significant reduction in\n                      <jats:italic>C. acnes<\/jats:italic>\n                      -related PSIIs. These findings should be considered hypothesis-generating and require confirmation in larger prospective studies. This simple, low-cost, and readily implementable adjunct may represent an effective addition to infection-prevention strategies in spinal surgery.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-026-10231-9","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:02:37Z","timestamp":1787202157000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative benzoyl peroxide 5% reduces early Cutibacterium acnes\u2013related postoperative spinal implant infections: a quasi-experimental study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0047-6634","authenticated-orcid":false,"given":"Giacomo","family":"Franceschi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2970-1276","authenticated-orcid":false,"given":"Mattia","family":"Marchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8048-956X","authenticated-orcid":false,"given":"Eugenio","family":"Dema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Palmisani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Aloisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9707-8389","authenticated-orcid":false,"given":"Mariachiara","family":"Pellegrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9786-3820","authenticated-orcid":false,"given":"Alessandra","family":"Soffritti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6922-5759","authenticated-orcid":false,"given":"Erica","family":"Franceschini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1254-9995","authenticated-orcid":false,"given":"Marianna","family":"Meschiari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2494-464X","authenticated-orcid":false,"given":"Stefania","family":"Casolari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6615-4198","authenticated-orcid":false,"given":"Cristina","family":"Mussini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4041-1459","authenticated-orcid":false,"given":"Andrea","family":"Bedini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"issue":"6","key":"10231_CR1","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1007\/s00586-009-1269-1","volume":"19","author":"AF Pull ter Gunne","year":"2010","unstructured":"Pull ter Gunne AF, van Laarhoven CJHM, Cohen DB (2010) Incidence of surgical site infection following adult spinal deformity surgery: an analysis of patient risk. 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