How would you manage an early postoperative spinal implant infection when intraoperative cultures while on antibiotics are negative, no frank purulence or other evidence of infection is observed during washout, but there were fascial defects and fluid tracking down to the hardware?

This is quite an interesting spread of responses. I avoid using the term “broad,” as it is not a meaningful concept in infectious diseases. Unfortunately, there are no randomized trials to guide our practice in PSI. The closest comparable evidence is likely from the DATIPO trial, where 12 weeks of t...

One question is why infection was suspected without purulence...perhaps systemic signs of infection? In that case, I would recommend 6 weeks of IV antibiotic therapy. Following this, I would give oral antibiotic suppression for at least 3 months. I would follow ESR, CRP. After that time, if there ar...