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Infection

Septic Arthritis Possible therapeutic alternatives
Septic arthritis – native joint S. aureus
Strept
Gram negative bacilli
MRSA unlikely:
[Nafcillin 2 grams ivpb q4h or Oxacillin 2 grams ivpb q4h] PLUS Ceftriaxone 2 grams ivpb q24h.
or 

Vancomycin (patient specific dosage regimen) +
Ceftriaxone 1-2g q24h

Septic arthritis– prosthetic joint S. epidermidis,
S. aureus
Gram negative bacilli
P. aeruginosa 
Vancomycin (patient specific dosage regimen) + Cefepime 2 gm IV q8-12h.
Gonococcal arthritis/ disseminated gonococcal infection  
 IV: Ceftriaxone 1g IV or IM q24h or Cefotaxime 1g IV q8h or ceftizoxime 1g IV q8h.

Oral: Cefixime or cefpodoxime 400mg orally twice daily.

[Also treat empirically for concomitant chlamydia infection: doxycycline 100 mg twice daily x 7 days or, if pregnant, azithromycin 1000mg orally x 1. ]

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Septic Arthritis