Treatment trends and outcomes of pyogenic vertebral osteomyelitis in Japan, 2015-2023: A descriptive epidemiological study
Abstract
BACKGROUND: Pyogenic vertebral osteomyelitis (PVO) is a rare but serious disease that presents diagnostic and therapeutic challenges. Although recent studies provide limited insights into its management trends, data on antibiotic regimens and surgical procedures remain scarce. This study aimed to assess real-world treatment trends for PVO in Japan.
METHODS: We conducted a descriptive study using a hospital administrative database from 2015 to 2023. We included 1524 adult patients hospitalized for PVO in 50 hospitals that continuously contributed data during this period. We assessed antibiotic regimens (duration, trends in specific agents, and combination therapy), surgical procedures, and in-hospital mortality. We used the Cochran-Armitage trend test to evaluate annual changes, and examined factors associated with in-hospital mortality using univariable modified Poisson regression.
RESULTS: The median duration of antibiotic therapy was 54 days. Although the proportion of patients receiving cefazolin (slightly over half) remained unchanged, there was a marked increase in the use of broad-spectrum antibiotics such as ceftriaxone, vancomycin, and piperacillin-tazobactam. During the oral phase, minocycline (33.5 %) and levofloxacin (24.8 %) were the most commonly prescribed. Approximately 30 % of patients received combination therapy, and this proportion did not change substantially over time. Surgical interventions increased during the study period, primarily because of rising…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,524 participants or records.
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