How long would you hold antibiotics before performing a vertebral biopsy to optimize culture yield in a patient who has been on empiric antibiotics for a week for suspected vertebral osteomyelitis?  

I think the heart of this question is to better understand why the patient was started on empiric antibiotics. The 2015 IDSA guidelines for vertebral osteo endorse holding abx in clinically stable patients to optimize cultures, which is obviously the most ideal situation, and where I have pushed for...

I would devote my efforts to obtaining a sample for WGS or other molecular technology and (briefly) delay sampling until an administrative route has been identified. If absolutely not available, antibiotics delay would depend on a) clinical status of the patient and b) tissue T1/2 of antibiotics adm...