Patient Population: Adult
| Diagnosis | Common Pathogens | Drug(s) of First Choice | Alternative Drug(s) | Comments | Expected Duration |
|---|---|---|---|---|---|
| Vertebral osteomyelitis without epidural abscess (no hardware in place) |
S. aureus Streptococci (anaerobic or aerobic) E.coli |
If patient is stable, has negative blood cultures, and is without epidural abscess, withhold antibiotics until bone biopsy and consult ID Ceftriaxone 2g IV q24h PLUS |
If patient is stable, has negative blood cultures, and is without epidural abscess, withhold antibiotics until bone biopsy and consult ID For severe PCN allergy: Aztreonam 2g IV q8h PLUS Vancomycin |
ID consultation recommended | |
| Vertebral osteomyelitis with epidural abscess (no hardware in place) | See Epidural Abscess | ID consultation recommended |
2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clinical Infectious Diseases, Volume 61, Issue 6, 15 September 2015, Pages e26–e46, https://doi.org/10.1093/cid/civ482