Li S, Rong H, Zhang X, et al. - In this systematic review involving 15,548 patients, researchers assessed the impact of topical vancomycin powder for a microbial profile in spinal surgical site infections. All available literature on the topical use of vancomycin powder for prevention of postoperative spinal infections has been retrieved from MEDLINE, EMBASE, and Cochrane databases from the date of creation until September 30, 2018. Findings suggested that topical administration of vancomycin powder in spinal surgical sites may not increase the rates of gram-negative bacterial or polymicrobial infection. On the contrary, infection rates of gram-positive bacteria, methicillin-resistant staphylococcus and microorganism can be considerably reduced. The topical vancomycin powder, of course, cannot change the rates of gram-negative bacterial infections that may be related to vancomycin's antimicrobial spectrum. Because of this study's limited number of articles, additional large-scale and high-quality studies are required to provide more reliable clinical evidence.