2022
DOI: 10.5194/jbji-7-249-2022
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Early switch to oral antibiotic therapy for the treatment of patients with bacterial native vertebral osteomyelitis: a quaternary center experience, systematic review, and meta-analysis

Abstract: Abstract. Recent data suggest that oral therapy can be effective for bone infections. We aim to assess the efficacy of an early switch to oral therapy (<2 weeks) compared to a non-early switch in bacterial native vertebral osteomyelitis. We conducted a cohort study at Mayo Clinic, Rochester (MN), between 2019–2021 combined with a systematic review, which queried multiple databases. Data were analyzed using a random-effects model. The cohort study included 139 patients: two received an early switch. Of 3708 … Show more

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Cited by 6 publications
(6 citation statements)
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“…The meta-analysis of seven observational comparative studies did not have enough evidence to show a higher efficacy of either group. Within the observational studies the authors determined high risk of bias due to differences in demographics, comorbidities, and other confounders between the patients in the two arms [ 11 ].…”
Section: Resultsmentioning
confidence: 99%
See 3 more Smart Citations
“…The meta-analysis of seven observational comparative studies did not have enough evidence to show a higher efficacy of either group. Within the observational studies the authors determined high risk of bias due to differences in demographics, comorbidities, and other confounders between the patients in the two arms [ 11 ].…”
Section: Resultsmentioning
confidence: 99%
“…There has been growing interest in exploring the role of oral antibiotic therapy or short-term parenteral therapy followed by oral antibiotics as a potential outpatient management option for chronic osteomyelitis [ 10 , 11 ]. Due to vascular impairment, it is a therapeutic challenge to deliver pharmaceutical agents to the site of osteitis [ 47 , 48 ].…”
Section: Discussionmentioning
confidence: 99%
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“…[2][3][4][5] However, the drawbacks of intravenous (IV) antibiotics include cost, barriers to coordinating and managing outpatient IV therapy, risk of IV line complications, and the considerable risk of toxicity from commonly used IV antibiotics, in particular vancomycin. 6 Despite numerous studies indicating that oral (PO) antibiotics are as effective as IV antibiotics for the treatment of orthopedic infections, [7][8][9][10][11][12][13][14][15] including a large randomized clinical trial, 14 clinicians in the United States (US) remain reluctant to use PO antibiotics for the treatment of these serious infections. 16,17 One possible explanation for this reluctance is that the most robust evidence for the equivalence of PO and IV antibiotics comes from a randomized clinical trial in the United Kingdom (the OVIVA trial), which included only a small number of patients (N = 19) with methicillin-resistant Staphylococcus aureus (MRSA).…”
mentioning
confidence: 99%