Post surgical deep spinal infection

Do not start antibiotic therapy until samples obtained if clinically stable.

Required investigations

Blood cultures X 2 sets 

Imaging and sampling (biopsy/surgical sampling)

Antibiotic recommendation

Recommended antibiotic

Ceftazadime 2g IV 8 hourly

PLUS

Vancomycin IV (use NHS Lothian Calculator on AMT intranet page); aim trough levels 15-20mg/L
Severe penicillin allergy or previous MRSA

Vancomycin IV (use NHS Lothian Calculator on AMT intranet page); aim trough levels 15-20mg/L

PLUS

Ciprofloxacin 400mg IV 8 hourly*

*Avoid fluoroquinolones if taking steroids and the elderly.

Review MHRA Quinolone Warning before prescribing.

If an alternative agent is required please contact microbiology

 

 

 

Recommended total duration

Discuss with microbiology and neurosurgery

Usually 6-12 weeks duration, longer duration may be required if metalwork retained

Notes:

Causative organisms include Staphylococcus, Gram-negative bacilli.