Malhotra N, Piazza M, Demoor R, et al. - Researchers examined if and how total preincision infusion time influence surgical site infections (SSIs). Further, they sought to determine an optimal time threshold for subsequent prospective study. They performed retrospective enrollment of all consecutive patients (n = 46,791) undergoing inpatient surgical intervention (2014–2015) and monitored them for 1 year. Findings suggest that Initially, national guidelines were rarely met by vancomycin infusion; however, there was no association of minimal compliance breach with SSI implications. Preincision infusion of vancomycin was performed in only 36.1% of patients in compliance with national and institutional standards (60–120 min). Fifty three times higher compliance was observed with cephalosporin infusion times. SSI was significantly predicted with significantly noncompliant, reduced preincision infusion time (< 24.6 min infusion). Increased SSI was predicted in correlation with vancomycin infusion, initiated too close to surgical incision. Improvement in vancomycin infusion start time and elimination of high-risk infusions (sub-24.6 min) were observed with implementation of an algorithm to improve infusion time, but not powered to demonstrate infection/reduction. A critical infusion time for infection reduction (24.6 min before incision) was thus suggested by the retrospective data assessed.