Tigecycline in the management of post-neurosurgical spondylodiscitis: a review of eight cases

SummaryBackgroundTigecycline is a relatively new glycylcycline antimicrobial, active in vitro against a variety of Gram-positive and Gram-negative organisms. In this study we evaluated the outcomes of spondylodiscitis cases treated with tigecycline-including therapies retrospectively.MethodsAll adult (age >18 years) cases with a diagnosis of spondylodiscitis, who were treated with a tigecycline-including therapy between 2007 and 2011, were included in the study. The primary efficacy outcome was clinical success with tigecycline at the end of induction, while the secondary efficacy outcome was maintenance of success through 3 months following completion of induction.ResultsA total of eight spondylodiscitis cases fulfilled the study inclusion criteria. All cases had back pain, restricted mobility, magnetic resonance findings associated with spondylodiscitis, and microbiology or pathological findings related to spondylodiscitis. All had post-neurosurgical spondylodiscitis. In five cases, tigecycline was started in accordance with the antibacterial susceptibility results from intervertebral tissue biopsy cultures, whereas in three it was started empirically. All cases had received several different antibacterials with failure before receiving tigecycline. The mean duration of tigecycline treatment was 37 ± 21 days. One case was lost to follow-up after 2 days of tigecycline. Primary and secondary success was achieved in the remaining seven cases.ConclusionsThese limited data suggest that tigecycline may have a role in the treatment of refractory spondylodiscitis cases.