PDG-PET/CT vs MRI: diagnostic value for spondylodiscitis

• Retrospective study (2006-2013): N=70 pts with a clinical suspicion of

spondylodiscitis or an infection or fever of unknown origin,

undergoing 18F-fluorodeoxyglucose (FDG) PET/CT + contrast-enhanced

MRI of the spine within ≤ 2 wk

• Exclusion criteria: MRI or FDG-PET/CT ≤6 wk after spinal surgery; known

final fracture; no final clinical diagnosis

• Final clinical diagnosis of spondylodiscitis: 50/70 pts (71%):

– Based on positive cultures of blood and/or tissue

+ imaging suggestive of spondylodiscitis: 94%

– Based on imaging suggestive of spondylodiscitis

+ response to antibiotic Tx: 6%

Smids C. ECCMID 2014 abs. eP227

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Data from poster

PDG-PET/CT vs MRI: diagnostic value for spondylodiscitis

Compared with MRI, FDG-PET/CT has a superior diagnostic value for detecting early (<2 wk) spondylodiscitis and a higher sensitivity for

detecting paravertebral and psoas abscesses

Smids C. ECCMID 2014 abs. eP227

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Data from poster

Antibiotic treatment (Tx) for vertebral osteomyelitis (VO)

• Multi-centre, non-inferiority RCT: N=351 pts with VO (mean age: 61 yr; 69% male): 6 weeks antibiotic Tx vs 12 weeks antibiotic Tx

• Most frequently prescribed antibiotics:

– For S. aureus: rifampicin (87.6%), fluoroquinolones (83.4%), methicillin (75.9%), aminoglycosides (74.5%)

– For Streptococcus spp: aminopenicillin (92.1%)

– For IE: aminoglycosides (80.4%), aminopenicillin (50%)

– Combination therapy: fluoroquinolones + rifampicin (79.1%)

Dinh A. ECCMID 2014 abs. O258

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Antibiotic treatment (Tx) for vertebral osteomyelitis (VO)

• Median duration of iv antibiotic Tx: 20.8 days

• Intolerance to antibiotic Tx: N=29

• Vancomycin: responsible for 21.1% of adverse events

6 weeks antibiotic Tx for VO seems to be non-inferior to 12 weeks Tx

Dinh A. ECCMID 2014 abs. O258

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