Musculoskeletal infections

Question 1

Osteomyelitis

Answer 1

Flucloxacillin
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection
If penicillin-allergic, clindamycin
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection
If meticillin-resistant Staphylococcus aureus suspected, vancomycin (or teicoplanin)
Consider adding fusidic acid or rifampicin for initial 2 weeks.
Suggested duration of treatment 6 weeks for acute infection

Question 2

Septic Arthritis

Answer 2

Flucloxacillin
Suggested duration of treatment 4–6 weeks (longer if infection complicated).
If penicillin-allergic, clindamycin
Suggested duration of treatment 4–6 weeks (longer if infection complicated).
If meticillin-resistant Staphylococcus aureus suspected, vancomycin (or teicoplanin)
Suggested duration of treatment 4–6 weeks (longer if infection complicated).
If gonococcal arthritis or Gram-negative infection suspected, cefotaxime (or ceftriaxone)
Suggested duration of treatment 4–6 weeks (longer if infection complicated; treat gonococcal infection for 2 weeks).