{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T03:41:58Z","timestamp":1788838918374,"version":"build-2803163510"},"reference-count":17,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR001105"],"award-info":[{"award-number":["UL1TR001105"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08AI180362"],"award-info":[{"award-number":["K08AI180362"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Trauma Research and Combat Casualty Care Collaborative","award":["TRC4-2025\u20130000000028"],"award-info":[{"award-number":["TRC4-2025\u20130000000028"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative spinal implant infections (PSIIs) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective cohort study across 10 US academic centers, including adults with early PSII (\u226490 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 \u2264 12 weeks versus &amp;gt;12 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 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 6 weeks from debridement, being on antibiotics was not associated with treatment failure (adjusted hazard ratio [aHR] 0.71; 95% CI .48\u20131.07; P = .10). In a 12-week landmark analysis limited to 359 patients who were not on indefinite suppressive antibiotic therapy, treatment durations &amp;gt; 12 weeks did not significantly reduce the risk of failure (aHR 1.01; 95% CI .62\u20131.64; P = .99). Results were consistent in the clone-censor-weight sensitivity analysis (aHR 0.85; 95% CI .62\u20131.16; P = .30).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag300","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:26:18Z","timestamp":1777724778000},"source":"Crossref","is-referenced-by-count":1,"title":["Antibiotic Duration After Debridement and Implant Retention for Early Postoperative Spinal Implant Infections: A Multicenter Cohort Study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0581-8015","authenticated-orcid":false,"given":"Don Bambino Geno","family":"Tai","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and International Medicine, University of Minnesota Medical School , Minneapolis, Minnesota ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Poehlein","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica C","family":"O'Neil","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Pennsylvania , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1949-7884","authenticated-orcid":false,"given":"Sandra B","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Department of Medicine; Harvard Medical School , Boston Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-7082","authenticated-orcid":false,"given":"Aaron J","family":"Tande","sequence":"additional","affiliation":[{"name":"Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic , Rochester, Minnesota ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1687-3346","authenticated-orcid":false,"given":"Daniela De Lima","family":"Corvino","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8216-3588","authenticated-orcid":false,"given":"Alaina S","family":"Ritter","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Medicine, University of Florida College of Medicine , Gainesville, Florida 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8579-4302","authenticated-orcid":false,"given":"Alexander M","family":"Tatara","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, The University of Texas Southwestern Medical Center , Dallas, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0186-5191","authenticated-orcid":false,"given":"Cynthia L","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly E","family":"Fleece","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6168-0175","authenticated-orcid":false,"given":"Daniel G","family":"Tobert","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Erickson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Duke University School of Medicine , Durham, North Carolina 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