Clinical Study
Lack of effect of antibiotics on biopsy culture results in vertebral osteomyelitis

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Abstract

We report a retrospective study of 173 patients with vertebral osteomyelitis evaluating the effect of antibiotics administered prior to percutaneous and open biopsy cultures. Antibiotics given prior to these biopsies did not have a significant effect on the yield of cultures.

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Cited by (11)

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    Antibiotics are often held before percutaneous biopsies due to prior evidence suggesting lower yield if given before intervention.15,22-25 However, more recent evidence seems to refute this,26,27 and our results similarly found that antibiotic administration did not negatively impact yield (OR 0.83: 95% CI, 0.35-2.00). This is likely because the duration of pre-procedure antibiotics was generally short (<72hours).

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    This result might be linked to the higher presence of further surgical approach detected in the negative culture group. As it has been pointed out in several studies delay in diagnosis is probably the main issue in VO.2,17 Moreover, since antibiotic withholding is widely recommended,1 these biopsies should be performed as soon as possible.

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    The high concordance of positive blood and biopsy cultures within the AS can be associated with its pathogenic mechanism, which is usually hematogenous seeding (25). Similar to this work, several previous studies showed that antimicrobial therapy administered before the bone biopsies did not affect the microbiology yield (7,8,13,18,26–29). In accordance with the Infectious Diseases Society of America guidelines (17), patients were defined to be on antibiotic/antimicrobial therapy if they received a dose of antimicrobials within 48 hours before the biopsy.

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