Acute Osteomyelitis / Septic Arthritis / Discitis
- Micro-organism
Staph. aureus, Streptococcal Spp., gram negative organisms incl Pseudomonas spp.
First Line
Flucloxacillin IV + Gentamicin IV
Septic arthritis - treat for 4-6 weeks
Osteomyelitis - treat for 6 weeks
Second line: mild intolerance or mild skin reaction
Cefotaxime IV or ceftriaxone IV + gentamicin IV
Septic arthritis - treat for 4-6 weeks
Osteomyelitis - treat for 6 weeks
Anaphylaxis (including severe skin reactions) to penicillin / cephalosporins or MRSA suspected
Vaoncomycin IV + Gentamicin IV
Septic arthritis - treat for 4-6 weeks
Osteomyelitis - treat for 6 weeks
- Notes
Pseudomonas likely in feet infections and sickle cell anaemia at any age
Review antibiotic choice once sensitivities available
IV therapy is usually continued for up to 14 days before IV to oral switch - discuss with microbiology / orthopaedics / paediatrics