Musculoskeletal system infections, antibacterial therapy

Question 1

What drugs are used for the treatment of Osteomyelitis?

• 1st line
• If penicillin allergic
• If suspect MRSA

Answer 1

Flucloxacillin

• IV
• 8 g daily in 3-4 divided doses
• consider adding fusidic acid (750 mg 3x a day PO) or rifampicin for initial 2 weeks
• acute infection: 6 weeks of treatment

Question 2

What drugs are used for the treatment of Septic Arthritis?

• 1st line
• Penicillin allergic
• If suspect MRSA

Answer 2

Flucloxacillin

Clindamycin if penicillin allergic

Vancomycin if MRSA suspected

Question 3

What drugs are used for the treatment of Osteomyelitis if the patient is penicillin allergic?

Answer 3

Clindamycin if penicillin allergic

• PO 150-300 mg every 6 hours increased to 450 mg if required
• IV or IM 0.6-2.7 g daily in 2-4 divided doses

Question 4

What drugs are used for the treatment of Osteomyelitis if MRSA is suspected?

Answer 4

Vancomycin if MRSA suspected

- IV 15-20 mg/kg every 8-12 hours