Antimicrobial prescribing: NHS Lothian
Blood cultures X 2 sets (10mls in each bottle)
Imaging and sampling (biopsy/surgical sampling)
Community spondylodiscitis
Do not start antibiotic therapy until deep samples obtained.
In a patient who is haemodynamically unstable/abnormal neurological exam/imaging shows evidence of spinal epidural abscess discuss with microbiology and neurosurgery
| Recommended antibiotic |
Flucloxacillin 2g IV 6 hourly |
| Severe penicillin allergy or previous MRSA | Vancomycin IV (use NHS Lothian Calculator on AMT intranet page); aim trough levels 15-20mg/L |
These groups are at a higher risk of Gram-negative infection
- elderly
- frail
- recurrent UTI
- recent urological or abdominal surgery
CONSIDER
Gentamicin IV Use NHS Lothian Calculator located AMT intranet page
Directed antimicrobial therapy is usually guided by microbiology and infection specialists.
Usually 6-12 weeks duration.
Causative organisms include; Staph aureus, streptococci.