What is your approach to monitoring of inflammatory markers during treatment of native vertebral osteomyelitis?   

As long as the patient is clinically stable and CRP is coming down, there is generally no need for follow up imaging. Key reference: Kowalski et al., PMID 16779743.Also, good to remember that ESR is a very expensive test which basically measures fibrinogen (may cost $500 or more since it has to be r...

Yes, I do check CRP once weekly. Like Dr. @Winslow - I try VERY hard NOT to order any follow-up MRI imaging - I also recommend the Kowalski paper from CID 2006 that Dr. Winslow referenced. Kowalski's definition of "improved CRP" was only that there was a 25% decrease at 4-8 weeks of follow-up compar...

For those that monitor weekly inflammatory marker(s), can I ask: how does it change your management when patients improve clinically but markers do not fall satisfactorily? Do you get follow-up imaging? Do you extend antibiotics? Both of these maneuvers seem to have the potential for harm in someone...