The incidence of infectious spondylodiscitis has been increasing over the last few years. This reflects the expanding elderly and immunocompromised populations and the rising implementation of invasive spinal procedures. Infection may be inoculated into the disc space directly during invasive spinal procedures. Osteomyelitis caused by Acinetobacter species is rare and mainly caused by multidrug-resistant strains.
We present the case of a 72-year-old Greek woman with postoperative spondylodiscitis caused by a multidrug-resistant Acinetobacter baumannii strain that was successfully treated, after she declined surgical treatment, with prolonged and high dosage of tigecycline. She received intravenously administered tigecycline 200 mg per day for 60 days and then 100 mg per day for a total of 102 days and was infection-free.
We reviewed the literature on the role of Acinetobacter baumannii as a cause of osteomyelitis, emphasizing the difficulty of treatment and the potential role of tigecycline in conservative treatment of the infection. We believe that 102 days in total is the longest time that any patient has received tigecycline in the literature, thus our patient is a unique case of successful treatment of spondylodiscitis.
Sipahi OR, Kahraman H, Mermer S, Pullukcu H, Tasbakan M, Arda B, Yamazhan T, Yurtseven T, Aydemir S, Ulusoy S. Tigecycline in the management of post-neurosurgical spondylodiscitis: a review of eight cases. Int J Infect Dis. 2014;23:16–9. doi: 10.1016/j.ijid.2014.01.027. Epub 2014 Mar 18. CrossRefPubMed
Tombs NL. Tissue distribution of GAR- 936, a broad spectrum antibiotic in male rats. In: Program and abstracts of the Thirty-ninth Interscience Conference on Antimicrobial Agents and Chemotherapy. Sep 26–29 (San Francisco). Washington: American Society for Microbiology; 1999. p. 413.
- Prolonged and high dosage of tigecycline – successful treatment of spondylodiscitis caused by multidrug-resistant Acinetobacter baumannii: a case report
- BioMed Central