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
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