Septic arthritis: 4 to 6 weeks
Osteomyelitis: up to 6 months
First 2 weeks - Flucloxacillin IV 1g to 2g 6 hourly
Then consider oral therapy
If infection not confirmed discuss with microbiology
If risk factors for gram negative infection (for example UTI, prostate symptoms, recent intra-abdominal surgery), add Gentamicin as extended interval dosing as per guideline. Use gentamicin calculator.
First 2 weeks - Vancomycin IV dosing as per guideline. Use vancomycin calculator.
Then consider oral therapy
If infection not confirmed discuss with microbiology
If risk factors for gram negative infection (for example UTI, prostate symptoms, recent intra-abdominal surgery), add Gentamicin as extended interval dosing as per guideline. Use gentamicin calculator.
Blood cultures, joint aspirates and other appropriate samples from potential source of infection MUST be taken prior to therapy.
Discuss with Consultant Microbiologist if risk of Methicillin resistant Staphylococcus aureus or Staphylococcus epidermidis or if gonococcal septic arthritis is suspected.
All therapy should be modified with culture results.
