Septic Arthritis/Osteomyelitis


Staphylococcus aureus, Streptococcus pyogenes


Discuss treatment duration and oral switch with infection specialist

  • 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
Septic Arthritis/Osteomyelitis - 1st Line

IV Flucloxacillin 2g 6 hourly initially

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

Add rifampicin for prosthetic joints after consultation with specialist


Septic Arthritis/Osteomyelitis - If penicillin allergy or MRSA likely

Vancomycin IV as per guideline

Use preferred calculator on Hospital portals page [intranet access only] or app for intermittent dosing