Cargando…
334. Treatment Duration of Antibiotics for Sacral Osteomyelitis After Skin Flap Procedure
BACKGROUND: Patients with spinal cord injuries frequently develop sacral osteomyelitis. Optimal treatment often involves intravenous antibiotics and skin flap closure of the ulcer; however, best practices for the duration of antibiotic therapy pre- and post-procedure are unknown. METHODS: This was a...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776350/ http://dx.doi.org/10.1093/ofid/ofaa439.530 |
_version_ | 1783630661961121792 |
---|---|
author | Frye, Emily Linneman, Travis W Moenster, Ryan P |
author_facet | Frye, Emily Linneman, Travis W Moenster, Ryan P |
author_sort | Frye, Emily |
collection | PubMed |
description | BACKGROUND: Patients with spinal cord injuries frequently develop sacral osteomyelitis. Optimal treatment often involves intravenous antibiotics and skin flap closure of the ulcer; however, best practices for the duration of antibiotic therapy pre- and post-procedure are unknown. METHODS: This was a retrospective, cohort study of spinal cord injury patients at the VA St. Louis undergoing a skin flap procedure from 1 October 2014 to 31 March 2019. Patients aged 18 to 89 years with a documented spinal cord injury and receiving treatment for sacral osteomyelitis with antibiotics and skin flap placement were considered for inclusion. The primary outcome was to determine if there was a difference in antibiotic treatment duration, both pre-procedure and post-procedure, between those that failed combination therapy and those patients for which the treatment was successful. Treatment failure was defined as documentation of no resolution of sacral osteomyelitis after treatment, re-initiation of antibiotics for sacral osteomyelitis of the same area, documented flap break-down, or an unplanned flap-related procedure within 1 year of completion of antibiotic therapy. RESULTS: Twelve patients were identified for inclusion. Baseline characteristics were similar between groups; 5/8 patients successfully treated received vancomycin, compared to 4/4 patients that failed therapy. Overall, 75% (8/12) had a successful treatment outcome at 12 months. In qualifying patients, average days of pre-procedure and post-procedure antibiotics were similar between patients who achieved success and those who failed (45.5 vs. 44.3 days pre-procedure, respectively (p >0.05) and 39 vs. 43 days post-procedure (p >0.05), respectively). When evaluated by weeks of therapy, no statistically significant differences were noted in treatment success rates between those treated for less than 6 weeks versus those treated for longer (66.6% [2/3] vs. 63.6% [6/9], p >0.05). CONCLUSION: No difference in pre- or post-flap procedure antibiotic duration was observed in patients who failed therapy compared to those who were successfully treated. DISCLOSURES: All Authors: No reported disclosures |
format | Online Article Text |
id | pubmed-7776350 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77763502021-01-07 334. Treatment Duration of Antibiotics for Sacral Osteomyelitis After Skin Flap Procedure Frye, Emily Linneman, Travis W Moenster, Ryan P Open Forum Infect Dis Poster Abstracts BACKGROUND: Patients with spinal cord injuries frequently develop sacral osteomyelitis. Optimal treatment often involves intravenous antibiotics and skin flap closure of the ulcer; however, best practices for the duration of antibiotic therapy pre- and post-procedure are unknown. METHODS: This was a retrospective, cohort study of spinal cord injury patients at the VA St. Louis undergoing a skin flap procedure from 1 October 2014 to 31 March 2019. Patients aged 18 to 89 years with a documented spinal cord injury and receiving treatment for sacral osteomyelitis with antibiotics and skin flap placement were considered for inclusion. The primary outcome was to determine if there was a difference in antibiotic treatment duration, both pre-procedure and post-procedure, between those that failed combination therapy and those patients for which the treatment was successful. Treatment failure was defined as documentation of no resolution of sacral osteomyelitis after treatment, re-initiation of antibiotics for sacral osteomyelitis of the same area, documented flap break-down, or an unplanned flap-related procedure within 1 year of completion of antibiotic therapy. RESULTS: Twelve patients were identified for inclusion. Baseline characteristics were similar between groups; 5/8 patients successfully treated received vancomycin, compared to 4/4 patients that failed therapy. Overall, 75% (8/12) had a successful treatment outcome at 12 months. In qualifying patients, average days of pre-procedure and post-procedure antibiotics were similar between patients who achieved success and those who failed (45.5 vs. 44.3 days pre-procedure, respectively (p >0.05) and 39 vs. 43 days post-procedure (p >0.05), respectively). When evaluated by weeks of therapy, no statistically significant differences were noted in treatment success rates between those treated for less than 6 weeks versus those treated for longer (66.6% [2/3] vs. 63.6% [6/9], p >0.05). CONCLUSION: No difference in pre- or post-flap procedure antibiotic duration was observed in patients who failed therapy compared to those who were successfully treated. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7776350/ http://dx.doi.org/10.1093/ofid/ofaa439.530 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Frye, Emily Linneman, Travis W Moenster, Ryan P 334. Treatment Duration of Antibiotics for Sacral Osteomyelitis After Skin Flap Procedure |
title | 334. Treatment Duration of Antibiotics for Sacral Osteomyelitis After Skin Flap Procedure |
title_full | 334. Treatment Duration of Antibiotics for Sacral Osteomyelitis After Skin Flap Procedure |
title_fullStr | 334. Treatment Duration of Antibiotics for Sacral Osteomyelitis After Skin Flap Procedure |
title_full_unstemmed | 334. Treatment Duration of Antibiotics for Sacral Osteomyelitis After Skin Flap Procedure |
title_short | 334. Treatment Duration of Antibiotics for Sacral Osteomyelitis After Skin Flap Procedure |
title_sort | 334. treatment duration of antibiotics for sacral osteomyelitis after skin flap procedure |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776350/ http://dx.doi.org/10.1093/ofid/ofaa439.530 |
work_keys_str_mv | AT fryeemily 334treatmentdurationofantibioticsforsacralosteomyelitisafterskinflapprocedure AT linnemantravisw 334treatmentdurationofantibioticsforsacralosteomyelitisafterskinflapprocedure AT moensterryanp 334treatmentdurationofantibioticsforsacralosteomyelitisafterskinflapprocedure |