Vertebral Osteomyelitis
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| Vertebral Osteomyelitis in adults | |||
|---|---|---|---|
| Definition | Signs/ Symptoms | Management | |
| Initial Empirical Therapy | Comment | ||
| Vertebral osteomyelitis is as infection of any portion of the spinal cord | Back pain localizes to infection site and is exacerbate by physical activity or palpitation of the effected area, pain may radiate to arm, shoulders, leg abdomen, Epidural abscess may present, motor weakness, loss of bowel and bladder control. |
Vancomycin 20 - 35 mg/kg/loading then 15 - 20 mg/kg IV every 8 to 12 hours PLUS Select one of the following Antibiotics: Ceftriaxone 2 g IV every 24 hours Cefotaxime 2 g IV every 6 - 8 hours Cefepime 2 g IV every 8 hours (IF pseudomonas suspected) Ceftazidime 2 g IV every 8 hours Ciprofloxacin 400 mg IV every 12 hours Alternative: Piperacillin/Tazobactam 4.5 g IV every 6 hours Meropenem 1 g IV every 8 hours |
All patients with vertebral osteomyelitis should undergo tissue biopsy for culture and histopathology, unless they have confirmed bacteremia due to organism commonly associated with spine infection.
|
Duration: 6 weeks
References:
2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults , last update 2018