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Review
. 2022 Nov 23;7(6):249-257.
doi: 10.5194/jbji-7-249-2022. eCollection 2022.

Early switch to oral antibiotic therapy for the treatment of patients with bacterial native vertebral osteomyelitis: a quaternary center experience, systematic review, and meta-analysis

Matteo Passerini  1 , Julian Maamari  1 , Tarek Nayfeh  1 , Leslie C Hassett  2 , Aaron J Tande  1 , Mohammad H Murad  1 , Zelalem Temesgen  1 , Elie F Berbari  1
Affiliations
Review

Early switch to oral antibiotic therapy for the treatment of patients with bacterial native vertebral osteomyelitis: a quaternary center experience, systematic review, and meta-analysis

Matteo Passerini et al. J Bone Jt Infect. .

Abstract

Recent data suggest that oral therapy can be effective for bone infections. We aim to assess the efficacy of an early switch to oral therapy ( < 2 weeks) compared to a non-early switch in bacterial native vertebral osteomyelitis. We conducted a cohort study at Mayo Clinic, Rochester (MN), between 2019-2021 combined with a systematic review, which queried multiple databases. Data were analyzed using a random-effects model. The cohort study included 139 patients: two received an early switch. Of 3708 citations, 13 studies were included in the final analysis. Meta-analysis demonstrated no difference in treatment failure (odds ratio = 1.073, 95 % confidence interval 0.370-3.116), but many studies presented high risk of bias. Current evidence is insufficient to conclude the proportion of patients with failure or relapse is different in the two groups. High-quality studies are warranted before early switch can be routinely recommended.

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Conflict of interest statement

At least one of the (co-)authors is a member of the editorial board of . The peer-review process was guided by an independent editor, and the authors also have no other competing interests to declare.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the studies included.
Figure 2
Figure 2
Meta-analysis of risk for failure and relapse between early switch and non-early switch to oral therapy for bacterial NVO (CI, confidence interval; Obs, observational, RCT, randomized clinical trial, Ev, events).
Figure 3
Figure 3
Proportion of patients with failure and relapse among all the studies including a non-early switch (Ev, events; Trt, group of treated patients with non-early switch).
See this image and copyright information in PMC

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