Articles | Volume 7, issue 6
https://doi.org/10.5194/jbji-7-249-2022
https://doi.org/10.5194/jbji-7-249-2022
Review
 | 
23 Nov 2022
Review |  | 23 Nov 2022

Early switch to oral antibiotic therapy for the treatment of patients with bacterial native vertebral osteomyelitis: a quaternary center experience, systematic review, and meta-analysis

Matteo Passerini, Julian Maamari, Tarek Nayfeh, Leslie C. Hassett, Aaron J. Tande, Mohammad H. Murad, Zelalem Temesgen, and Elie F. Berbari

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Cited articles

Alshamsi, F., Belley-Cote, E., Cook, D., Almenawer, S. A., Alqahtani, Z., Perri, D., Thabane, L., Al-Omari, A., Lewis, K., Guyatt, G., and Alhazzani, W.: Efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials, Crit. Care, 20, 120, https://doi.org/10.1186/s13054-016-1305-6, 2016. 
Azamgarhi, T., Shah, A., and Warren, S.: Clinical Experience of Implementing Oral Versus Intravenous Antibiotics (OVIVA) in a Specialist Orthopedic Hospital, Clin. Infect. Dis., 73, e2582–e2588, https://doi.org/10.1093/cid/ciaa985, 2021. 
Babouee Flury, B., Elzi, L., Kolbe, M., Frei, R., Weisser, M., Schären, S., Widmer, A. F., and Battegay, M.: Is switching to an oral antibiotic regimen safe after 2 weeks of intravenous treatment for primary bacterial vertebral osteomyelitis?, BMC Infect. Dis., 14, 226, https://doi.org/10.1186/1471-2334-14-226, 2014. 
Berbari, E. F., Kanj, S. S., Kowalski, T. J., Darouiche, R. O., Widmer, A. F., Schmitt, S. K., Hendershot, E. F., Holtom, P. D., Huddleston, P. M., Petermann, G. W., and Osmon, D. R.: 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adultsa, Clin. Infect. Dis., 61, e26–e46, https://doi.org/10.1093/cid/civ482, 2015. 
Bernard, L., Dinh, A,, Ghout, I., Simo, D., Zeller, V., Issartel, B., Le Moing, V., Belmatoug, N., Lesprit, P., Bru, J.P., Therby, A., Bouhour, D., Dénes, E., Debard, A., Chirouze, C., Fèvre, K., Dupon, M., Aegerter, P., and Mulleman, D.: Duration of Treatment for Spondylodiscitis (DTS) study group. Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial, Lancet, 385, 875–882, https://doi.org/10.1016/S0140-6736(14)61233-2, 2015. 
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Short summary
Despite a growing interest in oral therapy for native vertebral osteomyelitis, there is no evidence to recommend oral or parenteral therapy. From our single-center experience combined with a systematic review and a meta-analysis of the available literature, there is insufficient evidence to conclude that there is a difference in proportion of failure and relapse between an early switch to oral antibiotics and prolonged parenteral therapy. Further studies are needed to increase the evidence.
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