BONE AND JOINT INFECTIONS Ongoing management / MINIMUM INFECTION Most likely causal organisms First choice duration of antibiotic therapy < 1 month of age treat with cefotaxime IV. Consider Staph. aureus ceftriaxone if weeks gestation and not jaundiced. Duration guided by clinical signs and CRP. ≥37 Strep. pneumoniae Children under 1 month of age with serious bacterial infection Usual: 4-6 wks Group A streptococcus require a LP unless contraindicated. Septic arthritis: 2-3 wks H. influenzae >1month- 5 years ceftriaxone IV. Kingella kingae Consider IV to oral switch when improvement in pain, resolution of fever and >=6 years flucloxacillin 50 mg/kg/qds IV (maximum Consider TB CRP<20mg/L or <1/3 of highest CRP 2g/dose) Salmonella in Sickle cell Osteomyelitis or Oral options include (clindamycin IV if penicillin allergy) septic arthritis cefalexin or co-amoxiclav or [clarithromycin if penicillin allergy]
BONE AND JOINT INFECTIONS INFECTION Most likely causal organisms First choice Ongoing management / MINIMUM duration of antibiotic therapy Osteomyelitis or septic arthritis Staph. aureus Strep. pneumoniae Group A streptococcus H. influenzae Kingella kingae Consider TB Salmonella in Sickle cell < 1 month of age treat with cefotaxime IV. Consider ceftriaxone if ≥37 weeks gestation and not jaundiced. Children under 1 month of age with serious bacterial infection require a LP unless contraindicated. >1month- 5 years ceftriaxone IV. >=6 years flucloxacillin 50 mg/kg/qds IV (maximum 2g/dose) (clindamycin IV if penicillin allergy) Duration guided by clinical signs and CRP. Usual: 4-6 wks Septic arthritis: 2-3 wks Consider IV to oral switch when improvement in pain, resolution of fever and CRP<20mg/L or <1/3 of highest CRP Oral options include cefalexin or co-amoxiclav or [clarithromycin if penicillin allergy]
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