Bone and Joint Infections

Question 1

What should you think about in septic arthritis/osteomyelitis?

Answer 1

Consider underlying metal work (may need replacement)
Recent surgery
Risk factors for MRSA (may need vancomycin)
Consider orthopaedic referral

Question 2

Which antibiotics would you use for septic arthritis/osteomyelitis in native joints?

What if the patient had a true penicillin allergy?

For how long?

Answer 2

IV flucloxacillin, PLUS
IV gentamicin

In penicillin allergy: IV vancomycin PLUS IV gentamicin

Duration: depends on surgical intervention; usually 4-6 weeks

Question 3

Which antibiotics would you use for septic arthritis/osteomyelitis in prosthetic joints?

For how long?

Answer 3

IV vancomycin, PLUS
IV gentamicin

Duration: depends on surgical intervention; usually 4-6 weeks

Question 4

Which antibiotics would you use for diabetic foot osteomyelitis?

For how long?

Answer 4

IV flucloxacillin, PLUS
IV gentamicin, PLUS
Oral metronidazole

4-6 weeks