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Chenoweth CE, Bassin BS, Mack MR, et al. Vertebral Osteomyelitis, Discitis, and Spinal Epidural Abscess in Adults [Internet]. Ann Arbor (MI): Michigan Medicine University of Michigan; 2018 Dec.
Initial Empiric Antibiotic Treatment of VO/SEAa
| Preferred: Vancomycinb IV per nomogram + ceftriaxone 2 g IV every12 hours |
| Alternative for suspected or documented pseudomonal infection: Vancomycinb IV per nomogram + cefepimeb 2 g IV every 8 hours |
| Alternative for penicillin allergy (non-anaphylaxis): Vancomycin IV per nomogram + meropenemb, c 2 g IV every 8 hours |
| Alternative for severe penicillin allergy: Vancomycinb IV per nomogram + aztreonamb 2 g IV every 6 hours |
| Alternative for vancomycin allergy or intolerance: Linezolidc 600 mg IV every12 hours + other antibiotic as indicated above. (Note: Caution should be advised when using linezolid in patients on medications with serotonergic activity, eg, SSRI and MAOI. Complete information regarding drug interactions with linezolid is available at: https://pharmwebsp |
Consult the infectious diseases service with any questions.
Note: Vancomycin trough target is 15-20 mcg/mL.
Treat vertebral osteomyelitis without spinal epidural abscess with lower doses of antibiotics or cefazolin per Infectious Diseases consultation guidance.
Adjust dose in patients with renal dysfunction.
Use requires prior Infectious Diseases approval.
From: Vertebral Osteomyelitis, Discitis, and Spinal Epidural Abscess in Adults
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