Factors associated with treatment failure in vertebral osteomyelitis requiring spinal instrumentation.

April 30, 2015 at 2:11 pm

Antimicrob Agents Chemother. 2014;58(2):880-4.

Arnold R1, Rock C, Croft L, Gilliam BL, Morgan DJ.

1Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Maryland, Baltimore, Maryland, USA.

Abstract

Patients with vertebral osteomyelitis may require instrumentation for spinal stabilization. Determining the optimal duration and type of antimicrobial therapy for these patients is challenging.

The aim of this study was to examine risk factors for treatment failure, in particular antimicrobial duration, in a cohort of patients requiring spinal instrumentation for vertebral osteomyelitis.

We conducted a retrospective cohort study of all patients with vertebral osteomyelitis who had spinal instrumentation between January 2002 and January 2012 at the University of Maryland Medical Center.

The primary outcome measure was treatment failure >4 weeks postoperatively.

We identified 131 patients with vertebral osteomyelitis requiring spinal instrumentation, 94 of whom had >4 weeks of follow-up and were included in the primary analysis. Treatment failure occurred in 22 of the 94 patients (23%) at a median of 4 months after surgery.

Among patients who failed therapy, 20 of 22 failed within 1 year of surgery. Cervical and thoracic infection sites and the presence of negative cultures were associated with fewer treatment failures.

Addition of rifampin and the use of chronic suppressive antimicrobials did not affect treatment failure rate.

Twenty-three percent of patients with spinal instrumentation for vertebral osteomyelitis experienced treatment failure.

Treatment failure almost always occurred within the first year of spinal instrumentation

PDF

http://aac.asm.org/content/58/2/880.full.pdf+html

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Infecciones osteo-articulares-musculares, Infecciones relacionadas a prótesis, Metodos diagnosticos, Sepsis. Tags: .

Asymptomatic bacteriuria in adults. Ceftolozane/Tazobactam Plus Metronidazole for Complicated Intra-abdominal Infections in an Era of Multidrug Resistance: Results From a Randomized, Double-Blind, Phase 3 Trial (ASPECT-cIAI)


Calendar

April 2015
M T W T F S S
« Mar   May »
 12345
6789101112
13141516171819
20212223242526
27282930  

Most Recent Posts


%d bloggers like this: