Patients with vertebral osteomyelitis who have had a recent spinal procedure
Broad-spectrum therapy is required for patients with vertebral osteomyelitis who have had a recent spinal procedure. For adults who have a normal neurological examination and no spinal epidural abscess, as a 2-drug regimen, use initially:
vancomycin intravenously; for initial dosing, see Intermittent vancomycin dosing for noncritically ill adults. See advice on intravenous to oral switch and duration of therapy vancomycin vancomycin vancomycin
PLUS
cefepime 2 g intravenously, 8-hourly. For dosage adjustment in adults with kidney impairment, see cefepime dosage adjustment. See advice on intravenous to oral switch and duration of therapy. cefepime cefepime cefepime
For adults who have had a nonsevere (immediate or delayed) hypersensitivity reaction to a penicillin, use cefepime plus vancomycin (see dosages above).
For adults who have had a severe immediate1 hypersensitivity reaction to a penicillin, cefepime plus vancomycin (at the dosages above) can be considered if a beta-lactam–based regimen is strongly preferred (for considerations, see Severe immediate hypersensitivity: Implications of cross-reactivity between penicillins and cephalosporins).
For adults who have had a severe immediate1 hypersensitivity reaction to a penicillin in whom cefepime plus vancomycin is not used, or for adults who have had a severe delayed2 hypersensitivity reaction to a penicillin, as a 2-drug regimen, use initially:
vancomycin intravenously; for initial dosing, see Intermittent vancomycin dosing for noncritically ill adults. See advice on intravenous to oral switch and duration of therapyvancomycinvancomycinvancomycin
PLUS EITHER
1ciprofloxacin 400 mg intravenously, 8-hourly. For dosage adjustment in adults with kidney impairment, see ciprofloxacin intravenous dosage adjustment. See advice on intravenous to oral switch and duration of therapy ciprofloxacin ciprofloxacin ciprofloxacin
OR
1ciprofloxacin 750 mg orally, 12-hourly. For dosage adjustment in adults with kidney impairment, see ciprofloxacin oral dosage adjustment. See advice on duration of therapyciprofloxacinciprofloxacinciprofloxacin.