Acute Osteomyelitis / Septic Arthritis / Discitis

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

Micro Organisms

Staph. aureus, Streptococcal Spp., gram negative organisms 

Duration

Septic arthritis - 2-3 weeks

Osteomyelitis - 4 weeks

First Line <5 years

Therapy

Ceftriaxone IV (high dose)

Notes:

First Line >5 years

Therapy

Flucloxacillin IV (high dose) and Gentamicin IV

Notes:

If gentamicin is not suitable use ceftriaxone

Anaphylaxis (including severe skin reactions) to penicillin or MRSA suspected - (Penicillin allergy)

Therapy

Vancomycin IV + Gentamicin IV 

Notes:

Notes

Review antibiotic choice once sensitivities available.

Review IV therapy after 72 hours. Discuss with microbiology / orthopaedics / paediatrics. 

Discuss oral switch once stable with microbiology - IVOST options likely to include co-trimoxazole PO. 

If lyme suspected refer to NICE guidelines here