Septic Arthritis/Osteomyelitis

Antimicrobial prescribing: NHS Grampian, Orkney & Shetland
NHS Grampian

Micro Organisms

Staphylococcus aureus, Streptococcus pyogenes

Duration

Discuss treatment duration and oral switch with infection specialist

Notes

Therapy

  • Send blood and if appropriate bone/joint fluid for culture
  • MRSA should be considered if the patient has been in hospital within the last 6 months
  • Septic arthritis - refer to orthopaedics for emergency drainage prior to initiation of antibiotics where possible
  • If recurrent - consider immune deficiency and testing for HIV

Notes:

Septic Arthritis/Osteomyelitis - 1st Line

Therapy

IV Flucloxacillin 2g 6 hourly initially

+/- IV/Oral Rifampicin 300mg - 600mg 12 hourly

Add rifampicin for prosthetic joints after consultation with specialist

Notes:

Septic Arthritis/Osteomyelitis - If penicillin allergy or MRSA likely

Therapy

Vancomycin IV as per guideline

Use calculator for intermittent dosing

Notes: