Page 40 - HPP ANTIMICROBIAL GUIDELINE 2018
        P. 40
     BONE & JOINT INFECTIONS
                                                                              Suggested Treatment
                          Infection/ Condition                                                                                      Comments
                                                                    Preferred                       Alternative
                 Acute osteomyelitis                     Cloxacillin 2gm IV q6h           Cefazolin 2gm IV 6-8hrly       Duration:
                                                                                                                         Initial IV therapy for 2-4 weeks
                                                                                                                         followed by oral therapy
                                                                                                                         Total duration of treatment minimum
                                                                                                                         6 weeks
                                                                                                                         Modify according to clinical response
                                                                                                                         A shorter duration  of antibiotics can
                                                                                                                         be considered if the osteomyelitic
                                                                                                                         bone is fully resected
                                                                                                                         ( i.e amputation with a  clear margin)
                 Chronic osteomyelitis                   Empirical treatment before taking                               Duration :
                                                         adequate cultures is not                                        6 weeks but usually > 3 months.
                                                         recommended.
                                                                                                                         A shorter duration  of antibiotics can
                                                         Choice of antibiotic depends on                                 be considered if the osteomyelitis is
                                                         C&S result from tissue/bone as                                  fully resected ( i.e amputation with a
                                                         swab culture NOT reliable.                                      clear margin)
                                                                                                                         Treat until inflammatory parameters
                                                                                                                         are normal.
                                                                                                                         Thorough surgical debridement
                                                                                                                         required.
                                                                                                                         (Removal of dead bone/ orthopaedic
                                                                                                                         hardware)
               HPP AMG                                                    Bone & Joints Infections                                                       15





