What is the optimal treatment of spinal infections caused by Propionibacterium acnes (P. acnes)?

Authors: Chad Craig, Dolors Rodriguez-Pardo, Evan Sheha

RECOMMENDATION: When possible, patients should undergo complete removal of implants after Cutibacterium acnes (C. acnes) (formerly P. acnes) infection, especially in the setting of latent infection. Antibiotic regimens typically involve specific parenteral antibiotics for a period of greater than two weeks, with the most common antibiotic duration being six weeks of multiple parenteral and/or oral agents. However, the duration of antibiotic treatment is highly variable. It is unclear in which setting patients may be successfully treated with antibiotic therapy alone and instrumentation may be retained. Penicillin is currently the standard of care, but other non beta-lactam antibiotics should be considered based on the susceptibility profile.

LEVEL OF EVIDENCE: Limited

DELEGATE VOTE: Agree: 73%, Disagree: 7%, Abstain: 20% (Super Majority, Strong Consensus)

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