Infectious spondylodiscitis.
OBJECTIVE
To review the available literature on infectious spondylodiscitis and provide recommendations on management, particularly identification of the causative agent and antimicrobial therapy.


RESULTS
The medical literature was searched using PubMed, employing the key words discitis, disc space infection, infectious spondylodiscitis, pyogenic discitis, septic discitis and post-operative discitis. Infectious spondylodiscitis is rising in incidence and diagnosis has been facilitated by the availability of sensitive imaging techniques such as MRI. No randomized controlled studies of antimicrobial therapy were identified in this literature search and there appear to be no UK consensus guidelines on investigation and management. Comprehensive French guidelines have been published and were scrutinized for this review.


CONCLUSIONS
Unless the patient is severely unwell antimicrobial therapy should be delayed until a microbiological diagnosis is established. If initial blood cultures are negative then a CT-guided biopsy should be conducted. Tentative recommendations for antimicrobial therapy can be made based on theoretical considerations and limited data from uncontrolled studies.
Cottle
Lucy
L
Department of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield, S10 2JF, UK.
Riordan
Terry
T
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D015299:Discitis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans
D000900:Anti-Bacterial Agents