Guidelines
Osteomyelitis or Septic Arthritis

Osteomyelitis or Septic Arthritis

Microbiology

Consults

Orthopedics, ID and/or relevant subspecialty team(s) if required

Clinical Considerations

This guidance is for patients aged ≥ 3 months

Consider need for source control with surgical drainage and/or debridement of the affected area.

Before starting antimicrobial therapy, take blood/urine/CSF and/or other relevant samples for culture wherever possible.

Consider the need for dose adjustments (e.g. renal impairment) and age-related contraindications for antimicrobials.

First Choice

OR

If not immunized

+/-

As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)

Penicillin Allergy

OR

If not immunized

+/-

As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)

Review Daily

Adjust treatment according to microbiologic results as soon as they become available.

Additional Information

The following factors have been associated with MRSA in previous studies:

  • Previous known MRSA infection in child or a significant contact (e.g. family member)
  • Family member is a healthcare worker
  • First nations child or Pacific Island origin (e.g. Samoan)
  • Day care attendance
  • Prolonged hospitalization in the last 1 year
  • Antibiotic therapy in the last 2 months
  • Critically ill
  • Chronic skin condition (e.g. atopic eczema)