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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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References - Infectious Disease Section

Infectious Disease References

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.
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