Treatment of pyogenic (non-tuberculous) spondylodiscitis with tailored high-dose levofloxacin plus rifampicin

Viale, Pierluigi; Furlanut, Mario; Scudeller, Luigia; Pavan, Federica; Negri, Camilla; Crapis, Massimo; Zamparini, Eleonora; Zuiani, Chiara; Cristini, Francesco; Pea, Federico

doi:10.1016/j.ijantimicag.2008.09.011

Cited by 38 publications

(20 citation statements)

References 15 publications

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“…The combination of an oral quinolone and rifampin resulted in success rates similar to that of the standard intravenous therapy in several studies (Schrenzel et al 2004;Viale et al 2009). Linezolid has an excellent bioavailability, but due to its bacteriostatic mode of action, it should only be used if other antimicrobials cannot be given (Berbari et al 2015).…”

Section: Antimicrobial Treatmentmentioning

confidence: 83%

Staphylococcus aureus-Associated Musculoskeletal Infections

Idelevich

Kreis

Löffler

et al. 2016

Current Topics in Microbiology and Immunology

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Musculoskeletal infections caused by Staphylococcus aureus are among the most difficult-to-treat infections. S. aureus osteomyelitis is associated with a tremendous disease burden through potential for long-term relapses and functional deficits. Although considerable advances have been achieved in diagnosis and treatment of osteomyelitis, the management remains challenging and impact on quality of life is still enormous. S. aureus acute arthritis is relatively seldom in general population, but the incidence is considerably higher in patients with predisposing conditions, particularly those with rheumatoid arthritis. Rapidly destructive course with high mortality and disability rates makes urgent diagnosis and treatment of acute arthritis essential. S. aureus pyomyositis is a common disease in tropical countries, but it is very seldom in temperate regions. Nevertheless, the cases have been increasingly reported also in non-tropical countries, and the physicians should be able to timely recognize this uncommon condition and initiate appropriate treatment. The optimal management of S. aureus-associated musculoskeletal infections requires a strong interdisciplinary collaboration between all involved specialists.

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Section: Antimicrobial Treatmentmentioning

confidence: 83%

Staphylococcus aureus-Associated Musculoskeletal Infections

Idelevich

Kreis

Löffler

et al. 2016

Current Topics in Microbiology and Immunology

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“…We also have to consider the risk factors involved, which include immunosuppression, obesity, alcohol, smoking, diabetes and malnutrition [10]. In conclusion, early diagnosis can decrease the morbidity and mortality of this disease [53,54].…”

Section: Resultsmentioning

confidence: 99%

Postoperative spondilodiscitis

Gerometta

Bittan

Olaverri

2012

International Orthopaedics (SICOT)

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Introduction Postoperative spondylodiscitis is a primary infection of the nucleus pulposus with secondary involvement of the cartilaginous endplate and vertebral bone. Although uncommon, postoperative spondylodiscitis causes major morbidity and may be associated with serious long-term sequelae. Several risk factors had been identified, including immunosuppression, obesity, alcohol, smoking, diabetes and malnutrition. Materials and methods A review of the literature was done to analyse the diagnosis, treatment and prevention of postoperative spondylodiscitis. Results We found that the principles of conservative treatment are to establish an accurate microbiological diagnosis, treat with appropriate antibiotics, immobilise the spine, and closely monitor for spinal instability and neurological deterioration. The purpose of surgical treatment is to obtain multiple cultures of bone and soft tissue, perform a thorough debridement of infected tissue, decompress neural structures, and reconstruct the unstable spinal column with bone graft with or without concomitant instrumentation. Conclusions Appropriate management requires aggressive medical treatment and, at times, surgical intervention. If recognised early and treated appropriately, a full recovery can often be expected. Therefore, clinicians should be aware of the clinical presentation of such infections to improve patient outcome. A review of the literature was done to advance our understanding of the diagnosis, treatment, prevention and outcome of these infections.

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“…It is controversial whether discitis can be caused by an aseptic or infectious process and positive cultures may be obtained only in 42–73% of patients 23. Early diagnosis is crucial in the management of discitis because delayed treatment can lead to increased morbidity and mortality 45. The mainstay for discitis treatment is a combination of bed rest and prolonged administration of antibiotics; surgical intervention is occasionally necessary in patients failing conservative treatment 6–10.…”

Section: Introductionmentioning

confidence: 99%

Postoperative discitis following single-level lumbar discectomy: Our experience of 17 cases

Basu¹,

Ghosh²,

Malik³

et al. 2012

IJOO

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Background:The established protocols of treatment of postoperative lumbar discitis have not been validated till date. We report a retrospective analysis of a series of patients with discitis following single level lumbar discectomy. We analyzed the outcome of conservative treatment of postoperative discitis with the objective to define when and what surgery was required when the conservative treatment failed.Materials and Methods:A total of 17 cases of postoperative discitis treated from 2002 to 2009 were followed up and evaluated clinically, radiologically and by laboratory investigations. All the patients were treated initially conservatively with rest and antibiotic therapy after diagnosis and those who did not respond to conservative treatment of at least 4 weeks were treated surgically. The cases were followed up with serial C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), X-ray, computed tomography (CT) scan and magnetic resonance imaging (MRI) for at least 1 year.Results:The mean followup was 40.38 months (range 12-86 months). Four cases failed to respond to conservative therapy and were treated surgically. In three of these four cases, open debridement, transpedicular fixation and posterolateral fusion was performed, and in the fourth case percutaneous transpedicular fixation was done. In the former group, one case was diagnosed to be tubercular, in another case Staphylococcus aureus was cultured where as the third case culture was sterile. All operated patients showed evidence of interbody fusion at 1 year followup.Conclusions:Early detection and aggressive treatment are paramount in managing postoperative discitis and the majority do well with conservative treatment. Surgical management in the form of transpedicular fixation and debridement, when required, gives excellent results.

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Treatment of pyogenic (non-tuberculous) spondylodiscitis with tailored high-dose levofloxacin plus rifampicin

Cited by 38 publications

References 15 publications

Staphylococcus aureus-Associated Musculoskeletal Infections

Staphylococcus aureus-Associated Musculoskeletal Infections

Postoperative spondilodiscitis

Postoperative discitis following single-level lumbar discectomy: Our experience of 17 cases

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