ArticlePloS one2019
Selection of an appropriate empiric antibiotic regimen in hematogenous vertebral osteomyelitis.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- The role of oral amoxicillin/clavulanic acid in the treatment of osteomyelitis: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Recommendations of the International Consensus Meeting (ICM) 2025 on Spinal Infections: Part A Pyogenic Spondylodiscitis.Global spine journal · 2026Article
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- Epidemiology and management of infectious spondylitis in Korea: a narrative review.Ewha medical journal · 2024Review
- Applying the German S2k-Guideline for Diagnosis and Treatment of Spondylodiscitis-A 5-Year Retrospective Evaluation of Patients without Neurological Symptoms.Diagnostics (Basel, Switzerland) · 2024Article
- Anterior Column Reconstruction of Destructive Vertebral Osteomyelitis at the Thoracolumbar Spine with an Expandable Vertebral Body Replacement Implant: A Retrospective, Monocentric Radiological Cohort Analysis of 24 Cases.Journal of clinical medicine · 2024Article
- A case of recurrent osteomyelitis due to retained micro-catheter after cerebral angiography.IDCases · 2024Article
- Risk Factors for the In-Hospital Mortality in Pyogenic Vertebral Osteomyelitis: A Cross-Sectional Study on 9753 Patients.Journal of clinical medicine · 2023Article
- The Epidemiology of Spondylodiscitis in Germany: A Descriptive Report of Incidence Rates, Pathogens, In-Hospital Mortality, and Hospital Stays between 2010 and 2020.Journal of clinical medicine · 2023Article
- Skeletal infections: microbial pathogenesis, immunity and clinical management.Nature reviews. Microbiology · 2022Review
- [Current practice of empiric antibiotic treatment for spondylodiscitis].Orthopadie (Heidelberg, Germany) · 2022Article
- [Common infectious challenges of the thoracic and lumbar spine : Spondylodiscitis and postoperative wound infection].Der Unfallchirurg · 2022Review
- Comparative study of culture, next-generation sequencing, and immunoassay for identification of pathogen in diabetic foot ulcer.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2021Observational
- Is There a Difference in Clinical Features, Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Healthcare-Associated and Community-Acquired Vertebral Osteomyelitis?Antibiotics (Basel, Switzerland) · 2021Article
- Article
- Does image-guided biopsy of discitis-osteomyelitis provide meaningful information to impact clinical management?Skeletal radiology · 2021Article
- Microbiologic Diagnosis of Pyogenic Spondylitis.Infection & chemotherapy · 2021Review
- Microbiological diagnosis of suspected vertebral osteomyelitis with a focus on the yield of percutaneous needle biopsy: a 10-year cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
- Case report of infective spondylodiscitis due to nalidixic acid-resistantJournal of family medicine and primary care · 2021Article
- Treatment and Clinical Outcomes of Osteoarticular Infections Among Pediatrics Admitted to Jimma University Medical Center, Ethiopia: A Prospective Observational Study.Infection and drug resistance · 2021Article
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Authors and funding
17 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmpiric antibiotic therapy for suspected hematogenous vertebral osteomyelitis (HVO) should be initiated immediately in seriously ill patients and may be required in those with negative microbiological results. The aim of this study was to inform the appropriate selection of empiric antibiotic regimens for the treatment of suspected HVO by analyzing antimicrobial susceptibility of isolated bacteria from microbiologically proven HVO.
methodWe conducted a retrospective chart review of adult patients with microbiologically proven HVO in five tertiary-care hospitals over a 7-year period. The appropriateness of empiric antibiotic regimens was assessed based on the antibiotic susceptibility profiles of isolated bacteria.
resultsIn total, 358 cases of microbiologically proven HVO were identified. The main causative pathogens identified were methicillin-susceptible Staphylococcus aureus (33.5%), followed by methicillin-resistant S. aureus (MRSA) (24.9%), Enterobacteriaceae (19.3%), and Streptococcus species (11.7%). Extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and anaerobes accounted for only 1.7% and 1.4%, respectively, of the causative pathogens. Overall, 73.5% of isolated pathogens were susceptible to levofloxacin plus rifampicin, 71.2% to levofloxacin plus clindamycin, and 64.5% to amoxicillin-clavulanate plus ciprofloxacin. The susceptibility to these oral combinations was lower in cases of healthcare-associated HVO (52.6%, 49.6%, and 37.6%, respectively) than in cases of community-acquired HVO (85.8%, 84.0%, and 80.4%, respectively). Vancomycin combined with ciprofloxacin, ceftriaxone, ceftazidime, or cefepime was similarly appropriate (susceptibility rates of 93.0%, 94.1%, 95.8%, and 95.8%, respectively).
conclusionsBased on our susceptibility data, vancomycin combined with a broad-spectrum cephalosporin or fluoroquinolone may be appropriate for empiric treatment of HVO. Fluoroquinolone-based oral combinations may be not appropriate due to frequent resistance to these agents, especially in cases of healthcare-associated HVO.
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