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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 274 - 283 (10page)
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초록· 키워드
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Background The optimal choice of antibiotics is challenging in culture-negative pyogenic spondylitis (PS). The empiric use of glycopeptides is suggested depending on various risk factors, although clinical data are sparse. This study aimed to analyze the clinical characteristics and outcomes of patients with culture-negative PS and evaluate the effect of empiric glycopeptide use on clinical outcomes in these patients. Materials and Methods Data on the characteristics, treatment, and outcomes of 175 patients diagnosed with PS were retrospectively obtained from the electronic database of a tertiary referral hospital from 2009 to 2016. Patients with negative culture results were grouped by the duration of glycopeptide treatment: glycopeptide therapy <28 days (Group A) and glycopeptide therapy ≥28 days (Group B). Results Of 89 patients with negative culture results, 78 were included in the analysis (Group A, n = 66; Group B, n = 12). The mean age of patients with negative culture results was 65.5 years, and 52.6% were male. The median follow-up duration was 573 (interquartile range [IQR], 83 – 1,037) days. The duration of intravenous glycopeptide therapy was 0.0 (IQR, 0.0 – 0.0) days and 55.5 (IQR, 37.0 – 75.7) days for Groups A and B, respectively. Patients who used glycopeptide longer empirically (Group B) had more commonly undergone a previous spinal procedure, including surgery (P = 0.024). The length of hospitalization, erythrocyte sedimentation rate, and C-reactive protein level were significantly higher in Group B compared with those in Group A (P <0.001, P <0.001, and P = 0.006, respectively). Regarding treatment modalities, patients in Group B underwent surgery more frequently (P = 0.017). The duration of parenteral antibiotic treatment was longer in Group B (P <0.001). Recurrence was noted in 7 patients (9.0%), and the recurrence rate was not significantly different between the 2 groups (Group A, 5/66 [7.6%]; Group B, 2/12 [16.7%]; P = 0.293). Conclusion The recurrence rate among patients with culture-negative PS was not different based on the duration of empiric glycopeptide use. However, considering the small sample size and heterogeneity of our study population, we suggest that it is reasonable to administer glycopeptide antibiotics in these patients depending on clinical risk factors. Further large-scale prospective studies are needed to obtain more evidence for appropriate antibiotic treatment.
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참고문헌 (19)
참고문헌 신청
Gouliouris T / 2010 / Spondylodiscitis: update on diagnosis and management / J Antimicrob Chemother 65(Suppl 3):iii11~iii24
Boody BS / 2015 / Vertebral osteomyelitis and spinal epidural abscess: an evidence-based review / J Spinal Disord Tech 28:E316~E327
Nickerson EK / 2016 / Vertebral osteomyelitis in adults : an update / Br Med Bull 117:121~138
정희진 / 2014 / Clinical Guidelines for the Antimicrobial Treatment of Bone and Joint Infections in Korea / Infection and Chemotherapy 46(2):125~138
Park KH / 2013 / Clinical characteristics and therapeutic outcomes of hematogenous vertebral osteomyelitis caused by methicillin-resistant Staphylococcus aureus / J Infect 67:556~564
Boody BS / 2015 / Vertebral osteomyelitis and spinal epidural abscess: an evidence-based review / J Spinal Disord Tech 28:E316~E327
Nickerson EK / 2016 / Vertebral osteomyelitis in adults : an update / Br Med Bull 117:121~138
정희진 / 2014 / Clinical Guidelines for the Antimicrobial Treatment of Bone and Joint Infections in Korea / Infection and Chemotherapy 46(2):125~138
Park KH / 2013 / Clinical characteristics and therapeutic outcomes of hematogenous vertebral osteomyelitis caused by methicillin-resistant Staphylococcus aureus / J Infect 67:556~564
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