2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6a8,Postoperative spinal implant infections (PSII) are a serious complication of instrumented spinal fusion. Although debridement with implant retention is standard for early infection, the optimal duration of antimicrobial therapy remains uncertain. We conducted a multicenter retrospective cohort study across ten U.S. academic centers, including adults with early PSII (≤90 days after fusion surgery) from 2017 to 2021. We excluded patients who experienced treatment failure within 6 weeks of debridement. The primary outcome was treatment failure. Antibiotic therapy effect was analyzed as a time-varying exposure using adjusted Cox proportional hazards models. Secondary analyses included 12-week landmark and clone-censor-weighted models to compare durations ≤12 weeks versus >12 weeks. 116 patients out of 499 (23.2%) experienced treatment failure during a median follow-up of 3.2 years. Among patients who remain failure-free six weeks from debridement, being on antibiotics was not associated with treatment failure (adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.48-1.07; p = 0.10). In a 12-week landmark analysis limited to 359 patients who were not on indefinite suppressive antibiotic therapy, treatment durations >12 weeks did not significantly reduce the risk of failure (aHR 1.01, 95% CI 0.62-1.64; p = 0.99). Results were consistent in the clone-censor-weight sensitivity analysis (aHR 0.85, 95% CI 0.62-1.16; p = 0.30). Prolonged antibiotic therapy was not associated with improved outcomes in early PSII managed with debridement and implant retention. These results support shorter, individualized antibiotic courses in patients with adequate surgical source control.31:T939,Abstract Background Postoperative spinal implant infections (PSII) are a serious complication of instrumented spinal fusion. Although debridement with implant retention is standard for early infection, the optimal duration of antimicrobial therapy remains uncertain. Methods We conducted a multicenter retrospective cohort study across ten U.S. academic centers, including adults with early PSII (≤90 days after fusion surgery) from 2017 to 2021. We excluded patients who experienced treatment failure within 6 weeks of debridement. The primary outcome was treatment failure. Antibiotic therapy effect was analyzed as a time-varying exposure using adjusted Cox proportional hazards models. Secondary analyses included 12-week landmark and clone-censor-weighted models to compare durations ≤12 weeks versus >12 weeks. Results 116 patients out of 499 (23.2%) experienced treatment failure during a median follow-up of 3.2 years. Among patients who remain failure-free six weeks from debridement, being on antibiotics was not associated with treatment failure (adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.48–1.07; p = 0.10). In a 12-week landmark analysis limited to 359 patients who were not on indefinite suppressive antibiotic therapy, treatment durations >12 weeks did not significantly reduce the risk of failure (aHR 1.01, 95% CI 0.62–1.64; p = 0.99). Results were consistent in the clone-censor-weight sensitivity analysis (aHR 0.85, 95% CI 0.62–1.16; p = 0.30). Conclusions Prolonged antibiotic therapy was not associated with improved outcomes in early PSII managed with debridement and implant retention. These results support shorter, individualized antibiotic courses in patients with adequate surgical source control. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Debridement and Implant Retention: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Debridement and Implant Retention (modality). 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Among patients who remain failure-free six weeks from debridement, being on antibiotics was not associated with treatment failure (adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.48-1.07; p = 0.10). In a 12-week landmark analysis limited to 359 patients who were not on indefinite suppressive antibiotic therapy, treatment durations >12 weeks did not significantly reduce the risk of failure (aHR 1.01, 95% CI 0.62-1.64; p = 0.99). Results were consistent in the clone-censor-weight sensitivity analysis (aHR 0.85, 95% CI 0.62-1.16; p = 0.30).","abstract":"$30","keywords":["Antibiotic duration","Debridement and implant retention","Musculoskeletal infection","Postoperative spinal implant infection","antimicrobial stewardship"],"pubmed_id":"42084484","conclusions":"","publication_date":"2026-05-05T00:00:00"},"crossref":{"DOI":"10.1093/cid/ciag300","URL":"https://doi.org/10.1093/cid/ciag300","ISSN":["1058-4838","1537-6591"],"link":[{"URL":"https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciag300/68213828/ciag300.pdf","content-type":"application/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciag300/68213828/ciag300.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Antibiotic Duration after Debridement and Implant Retention for Early Postoperative Spinal Implant Infections: A Multicenter Cohort Study"],"author":[{"given":"Don Bambino Geno","family":"Tai","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and International Medicine, University of Minnesota Medical School , Minneapolis, MN ,"}]},{"given":"Emily","family":"Poehlein","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine , Durham, NC ,"}]},{"given":"Jessica C","family":"O'Neil","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Pennsylvania , Philadelphia, PA ,"}]},{"given":"Sandra B","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, MA ,"},{"name":"Department of Medicine; Harvard Medical School , Boston MA ,"}]},{"given":"Aaron J","family":"Tande","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic , Rochester, MN ,"}]},{"given":"Daniela De Lima","family":"Corvino","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, AL ,"}]},{"given":"Alaina S","family":"Ritter","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Medicine, University of Florida College of Medicine , Gainesville, FL ,"}]},{"given":"Jenny","family":"Aronson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Stanford University , Stanford, CA ,"}]},{"given":"Laura","family":"Certain","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Utah , Salt Lake City, UT ,"}]},{"given":"Daisuke","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Stanford University , Stanford, CA ,"}]},{"given":"Alexander M","family":"Tatara","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, The University of Texas Southwestern Medical Center , Dallas, TX ,"}]},{"given":"Cynthia L","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine , Durham, NC ,"}]},{"given":"Tarek","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, AL ,"}]},{"given":"Molly E","family":"Fleece","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, AL ,"}]},{"given":"Daniel G","family":"Tobert","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School , Boston, MA ,"}]},{"given":"Melissa","family":"Erickson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Duke University School of Medicine , Durham, NC ,"}]},{"given":"Jessica","family":"Seidelman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Duke University School of Medicine , Durham, NC ,"}]},{"given":null,"family":null,"sequence":"additional","affiliation":[]},{"given":"Julie L","family":"Chan","sequence":"additional","affiliation":[]},{"given":"Nohra","family":"Chalouhi","sequence":"additional","affiliation":[]},{"given":"Matthew","family":"Decker","sequence":"additional","affiliation":[]},{"given":"Daniel J","family":"Hoh","sequence":"additional","affiliation":[]},{"given":"Tanvi","family":"Manohar","sequence":"additional","affiliation":[]},{"given":"Gregory","family":"Murad","sequence":"additional","affiliation":[]},{"given":"Steven G","family":"Roth","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,5,5]]},"member":"286","prefix":"10.1093","source":"Crossref","volume":null,"created":{"date-time":"2026-05-02T12:26:18Z","timestamp":1777724778000,"date-parts":[[2026,5,2]]},"indexed":{"date-time":"2026-05-05T14:14:53Z","timestamp":1777990493915,"date-parts":[[2026,5,5]]},"license":[{"URL":"https://academic.oup.com/pages/standard-publication-reuse-rights","start":{"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000,"date-parts":[[2026,5,5]]},"delay-in-days":0,"content-version":"am"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciag300/8667700"}},"subtitle":[],"deposited":{"date-time":"2026-05-05T13:50:13Z","timestamp":1777989013000,"date-parts":[[2026,5,5]]},"issn-type":[{"type":"print","value":"1058-4838"},{"type":"electronic","value":"1537-6591"}],"published":{"date-parts":[[2026,5,5]]},"publisher":"Oxford University Press (OUP)","reference":null,"short-title":[],"article-number":"ciag300","content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["Clinical Infectious Diseases"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,5,5]]},"references-count":0,"short-container-title":[],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1093/cid/ciag300","is_oa":false,"title":"Antibiotic Duration after Debridement and Implant Retention for Early Postoperative Spinal Implant Infections: A Multicenter Cohort Study","updated":"2026-05-07T14:04:23+00:00","published_date":"2026-05-02","best_oa_location":null}},"created_at":"2026-05-09T13:22:34.200Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1093/cid/ciag300","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"category","value":"Infectious Diseases","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"condition","value":"Postoperative Spinal Implant Infection","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"condition","value":"Surgical Site Infection","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"modality","value":"Antibiotic Therapy","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"modality","value":"Debridement and Implant Retention","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"sample_size","value":"n=499","value_numeric":499},{"paper_doi":"10.1093/cid/ciag300","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"warning","value":"140 patients on indefinite suppressive antibiotics were excluded from the landmark analysis; findings may not apply to this subgroup.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"warning","value":"The paper's DOI suffix 'ciag300' and publication date of May 5, 2026 are slightly ahead of today's date (May 9, 2026), suggesting this is a very recently published article with no post-publication commentary yet available.","value_numeric":null},{"paper_doi":"10.1093/cid/ciag300","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — while results challenge prolonged therapy, this is a retrospective study and randomized evidence is still lacking.","value_numeric":null}],"summaries":{"what_studied":"This multicenter retrospective cohort study across 10 U.S. academic centers evaluated whether antibiotic duration (≤12 weeks vs. >12 weeks) after debridement and implant retention affects treatment failure in 499 adults with early postoperative spinal implant infections (≤90 days post-fusion), followed for a median of 3.2 years (2017–2021).","key_result":"Treatment failure occurred in 116/499 patients (23.2%). Prolonged antibiotics (>12 weeks) did not reduce failure risk vs. ≤12 weeks (aHR 1.01, 95% CI 0.62–1.64; p=0.99), and being on antibiotics after 6 weeks of failure-free recovery was not independently protective (aHR 0.71, 95% CI 0.48–1.07; p=0.10).","limitations":"- Retrospective design limits causal inference; unmeasured confounders (e.g., antibiotic choice, organism virulence) may persist.\n- Patients on indefinite suppressive therapy (n=140) were excluded from the landmark analysis, which may limit generalizability to complex cases.\n- Duration categories were not randomized, and actual antibiotic regimens varied across 10 centers.","practice_takeaway":"For early postoperative spinal implant infections managed with debridement and implant retention, extending antibiotics beyond 12 weeks does not appear to improve outcomes. Clinicians can consider shorter, individualized courses once adequate surgical source control is achieved."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Debridement and Implant Retention"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Debridement and Implant Retention"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Debridement and Implant Retention"}}}]]

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