What is the role of antibiotics in the treatment of diskitis?

Updated: May 13, 2020
  • Author: Alvin Marcovici, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Answer

Antibiotic treatment must be tailored to the isolated organism and any other sites of infection. Broad-spectrum antibiotics must be used if no organism is isolated; however, this is very rare, and other disease processes (eg, spinal tuberculosis) must be considered in the face of persistently negative cultures.

Parenteral antibiotics are a requirement, even for outpatients. They are usually administered for 6-8 weeks. Before parenteral therapy is discontinued, the erythrocyte sedimentation rate (ESR) should have dropped by one half to one third, the patient should have no pain on ambulation, and there should be no neurologic deficits (see Complications and Long-Term Monitoring). [1, 3]

The use of oral antibiotics after intravenous (IV) treatment has not been shown to be of added benefit.

Any laboratory or clinical sign of persistent infection should prompt another biopsy and continued antibiotic therapy.


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