latrogenic Discitis: The Role of Intravenous Antibiotics in Prevention and Treatment

Publisher Website
Google Scholar
Abstract
The role of antibiotics in the treatment of latrogenic discitis remains controversial. This study was carried out to assess the ability of cephazolln (a firstgeneration cephalosporin) to penetrate the intervertebral disc and to establish the role of intravenous antibiotics in the prevention and treatment of iatrogenlc discitis.1 Six sheep had 1 g of intravenous antibiotic administered between 30 minutes and 120 minutes before being killed. Two adjacent lumbar intervertebral discs were harvested and assayed for antibiotic concentration. Cephazolln could only be detected in the animals killed at 30 minutes. Intravenous cephazolin was administered 30 minutes before bacterial inoculation in 46 discs of nine sheep. In five animals, the bacterial suspension contained radlographic contrast and, in four sheep, reconstituted chymopapain. No evidence of discitis was found at any level at death. Eight sheep were treated with intravenous cephazolin commencing 1, 2, or 3 weeks after bacterial intradiscal inoculation and for periods of up to 21 days. All discs developed discitis, and the lesions appeared to be similar, irrespective of time between inoculation and the commencement, duration, and dosage of antibiotic therapy. Our study supports the use of a suitable broad-spectrum antibiotic during any surgical procedure that invades the Intervertebral disc. Antibiotics, however, are unable to arrest the progression of discitis once it is established.

This publication has 0 references indexed in Scilit: