Brucella, in patients from endemic countries, can be as high as 25% of cases
Management
IV or highly bioavailable oral (metronidazole, fluoroquinolones, linezolid, TMP-SMX, clindamycin, and doxycycline/rifampin)
Can double-cover Enterococcus with an aminoglycoside for 4 to 6 weeks
Duration: 6 weeks for most, but 3 months for Brucella
Brucella
Doxycycline/rifampin
Duration: 3 months
Prognosis
Cure rates are 70-90% with 6 weeks of antibiotics, and are not higher with longer durations (per a single RCT)
Poor prognosis is associated with multidisc disease, the presence of concomitant epidural abscess, lack of surgical therapy, infection with S. aureus, old age, or the presence of significant comorbidities
References
^Kivanc Atesok, Alexander Vaccaro, Martina Stippler, Brendan M. Striano, Michael Carr, Michael Heffernan, Steven Theiss, Efstathios Papavassiliou. Fate of Hardware in Spinal Infections. Surgical Infections. 2020;21(5):404-410. doi:10.1089/sur.2019.206.
