This very popular paper from Korea suggests some patients need 8+ weeks for vertebral osteomyelitis based on risk factors. Those cut-offs were decided by the authors in their analysis it seems. Is this the origin?
Probably... it is the only one to my knowledge to propose specifically this duration... and the team was quite virulent against 6 weeks when the DTS study was published
But we used really different modalities of antibiotic therapy which could explain the differences ...
It’s like everything else related to duration. Somebody made it up.
However, I’ve never heard of 8 weeks for spinal osteo so perhaps that’s a more local custom.
I think this is where art of medicine comes into play.
It’s a disease for which there is no “test of cure”, and oftentimes a scary experience for the pt.
I too have extended antibiotics after 6 weeks, usually a couple of week increments to allow a pt to understand their baseline and maintain trust.
I believe there is an old IDSA MRSA guideline that recommends 8 weeks for VOM. That is where I thought it came from. I am sure it is just based on expert opinion at the time.
Comments
https://academic.oup.com/cid/article/62/10/1262/2462706
But we used really different modalities of antibiotic therapy which could explain the differences ...
However, I’ve never heard of 8 weeks for spinal osteo so perhaps that’s a more local custom.
@cortes-penfield.bsky.social
@jonathanrydermd.bsky.social
https://pubmed.ncbi.nlm.nih.gov/25468170/
It’s a disease for which there is no “test of cure”, and oftentimes a scary experience for the pt.
I too have extended antibiotics after 6 weeks, usually a couple of week increments to allow a pt to understand their baseline and maintain trust.
More is the exception