Medical School, University Augsburg, Augsburg, Germany.
Department of Neurosurgery, University Hospital Augsburg, Augsburg, Germany.
Neurosurg Rev. 2024 Nov 23;47(1):868. doi: 10.1007/s10143-024-03127-z.
Prolonged antibiotic therapy is often recommended for the treatment of spinal infections. This study aimed to evaluate the efficacy and safety of outpatient intravenous (IV) antibiotic therapy for spinal neurosurgery patients with spondylodiscitis. We carried out a retrospective study involving 67 patients who were administered peripherally inserted central catheter (PICC) for IV antibiotic treatment from January 2020 to December 2022. We assessed patient data concerning infections and neurosurgical concerns. Each patient underwent a minimum of 6 weeks of IV antibiotics, both as inpatients and outpatients. The study included 67 patients with a median age of 61 years (SD +/- 14.18 years), with approximately 44% being female. The average hospital stay for inpatient treatment was 20 days (SD +/- 8.8 days). Subsequent outpatient antibiotic therapy lasted an average of 70.32 days (SD +/- 18.24 days), with outpatient IV therapy accounting for 44.74 days (SD +/- 9.15 days). The most common pathogens identified were Staphylococcus epidermidis and methicillin-sensitive Staphylococcus aureus. Microbiological analysis did not detect any pathogens in 18% of patients. Radiographic and laboratory evidence of spondylodiscitis was absent in 99% of patients during the final follow-up. No catheter-related complications occurred. Outpatient IV antibiotic therapy using a PICC line catheter is a safe and effective treatment option for spinal infections, especially in elderly patients.
长时间的抗生素治疗常被推荐用于治疗脊柱感染。本研究旨在评估门诊静脉(IV)抗生素治疗脊柱神经外科患者脊椎炎的疗效和安全性。我们进行了一项回顾性研究,涉及 2020 年 1 月至 2022 年 12 月期间接受外周静脉穿刺中心静脉置管(PICC)IV 抗生素治疗的 67 例患者。我们评估了与感染和神经外科相关的患者数据。每位患者至少接受了 6 周的 IV 抗生素治疗,包括住院和门诊治疗。该研究包括 67 例患者,中位年龄为 61 岁(SD +/- 14.18 岁),约 44%为女性。住院治疗的平均住院时间为 20 天(SD +/- 8.8 天)。随后的门诊抗生素治疗平均持续 70.32 天(SD +/- 18.24 天),门诊 IV 治疗占 44.74 天(SD +/- 9.15 天)。最常见的病原体是表皮葡萄球菌和甲氧西林敏感金黄色葡萄球菌。18%的患者微生物分析未检出病原体。在最后一次随访时,99%的患者影像学和实验室均无脊椎炎证据。无导管相关并发症发生。使用 PICC 导管的门诊 IV 抗生素治疗是脊柱感染的一种安全有效的治疗选择,特别是在老年患者中。