Template:Septic Arthritis Antibiotics

For adults treatment should be divided into Gonococcal and Non-Gonococcal

Gonococcal

• Ceftriaxone 1g IV once daily
• Cefixime 400 mg PO BID is an option for outpatient therapy after initial 3 days of Ceftriaxone

Non-Gonococcal

• Treatment should cover S. aureus, Streptococcus, Pseudomonas, Enterococcus, B. burgdorferi
• Vancomycin 15-20 mg/kg IV BID PLUS any of the following:
  • Ceftriaxone 2g IV once daily
  • Cefepime 2g IV three times daily
  • Ceftazidime 2g IV three times daily
  • Ciprofloxacin 400mg IV three times daily

Pediatrics

Neonates (<3 months)

• Nafcillin 50mg/kg IV q6hrs + Cefotaxime 50mg/kg IV q8hrs

Children (>3 months)

• Ceftriaxone 50-75mg/kg IV daily (max 2g) OR
• Cefazolin 25mg/kg IV q8hrs (max 2g/dose)
• If MRSA suspected: Vancomycin 15mg/kg IV q6hrs OR Clindamycin 10-13mg/kg IV q8hrs (max 900mg/dose)

Sickle Cell

Coverage for Salmonella and Staphylococcus spp

• Vancomycin 20mg/kg IV twice daily PLUS
  • Ciprofloxacin 400mg IV three times daily OR
  • Imipenem/Cilastatin 1g IV three times daily