How long should antibiotics be administered after surgical debridement for an acute postsurgical spinal infection?

Author: Yvonne Achermann

RECOMMENDATION: For vertebral osteomyelitis: Initial intravenous treatment for one to two weeks, followed by an oral treatment of four to five weeks to reach a total treatment duration of six weeks. For deep surgical site infections: There is limited knowledge about the ideal duration of antibiotic treatment and which intravenous and/or oral agents should be given. As extrapolated from studies in periprosthetic joint infections (PJIs) and retrospective studies in spine infections, 12 weeks of antibiotic treatment can be recommended in cases with early infection and implant retention, six weeks if the implant is removed and prolonged suppressive treatment in delayed infections without removal of the implant.

LEVEL OF EVIDENCE: Moderate for vertebral osteomyelitis. Limited for surgical site infections after spine surgery

DELEGATE VOTE: Agree: 80%, Disagree: 13%, Abstain: 7% (Super Majority, Strong Consensus)