Septic Arthritis

Question 1

What should be your 1st line drug treatment for septic arthritis?

For what duration and via what route?

If this is contraindicated, what should you give instead?

What group of bacterias does this drug(s) cover?

Answer 1

i.v. Flucloxacillin for 2-3 weeks then oral Flucloxacillin for 2-4 weeks.

If Penicillins are contraindicated then give Macrolides as they target the same group discussed below - give Clindamycin

Covers gram positive cocci (for septic arthritis, need to initially ensure that the drug can cover Staphylococcus aureus and Streptococcus species as you need to give treatment prior to culture results in order to save the function of the joint)

Question 2

If MRSA is suspected to be the causative pathogen, what drug should you give and via what route?

Include the durations

Answer 2

i.v. Vancomycin for 3-4 weeks then oral Vancomycin for 2(+) weeks.

Question 3

If gonococcal arthritis is suspected. Describe its drug treatment.

Name an alternative drug that can be given.

Answer 3

i.v. Cefotaxime for 2 weeks then switch to oral Cefotaxime for 2-4 weeks

Ceftriaxone.

Question 4

If a gram negative organism is suspected to be the cause. Describe its drug treatment.

Name an alternative drug that can be given.

Answer 4

i.v. Cefotaxime for 2-3 weeks then oral Cefotaxime for 2-4 weeks

Ceftriaxone