12. Musculoskeletal

Infection

IV treatment

Oral treatment

Total duration

Septic arthritis and Osteomyelitis

Flucloxacillin 2g every 6 hours IV plus oral ciprofloxacin 500 - 750 mg every 12 hours
Amend according to cultures

According to cultures

Prolonged treatment is necessary. Intravenous treatment for 3 to 4 weeks. Usual total treatment duration is 4-6 weeks.

Septic arthritis and Osteomyelitis if penicillin allergic

Clindamycin 450mg every 6 hours IV plus oral ciprofloxacin 500 - 750 mg every 12 hours
Amend according to cultures

According to cultures

Prolonged treatment is necessary. Intravenous treatment for 3 to 4 weeks. Usual total treatment duration is 4-6 weeks.

Consult microbiologist at earliest opportunity, particularly if there is history of foreign travel, associated GU infection, presence of prosthetic joint or metalwork or pre-existing joint pathology
Modify antibiotic therapy based on culture results in consultation with microbiologist.

Infection	IV treatment	Oral treatment	Total duration
Septic arthritis and Osteomyelitis	Flucloxacillin 2g every 6 hours IV plus oral ciprofloxacin 500 - 750 mg every 12 hours Amend according to cultures	According to cultures	Prolonged treatment is necessary. Intravenous treatment for 3 to 4 weeks. Usual total treatment duration is 4-6 weeks.
Septic arthritis and Osteomyelitis if penicillin allergic	Clindamycin 450mg every 6 hours IV plus oral ciprofloxacin 500 - 750 mg every 12 hours Amend according to cultures	According to cultures	Prolonged treatment is necessary. Intravenous treatment for 3 to 4 weeks. Usual total treatment duration is 4-6 weeks.