Info

🌱 來自: bacterial arthritis

Treatment for native joints

Prompt empiric antibiotics guided by Gram stain after surgical drainage. If Gram stain ⊖, empiric Rx w/ vancomycin; add anti-pseudomonal agent if IVDU or immunocompromised.

GPC clusters

• S. aureus (most common)

  • Normal joints
  • Prosthetic joints
  • Damaged joints

• S. epidermidis

  • Prosthetic joints
  • Postprocedure
  • Treatment: Vancomycin. Can later Δ to antistaphylococcal penicillin or cefazolin based on sensitivities.

GPC chains

• Streptococci
• Healthy adults
• Splenic dysfunction
  • Treatment: PCN-G or ampicillin

GN

• Diplococci:
  • N. gonorrhea
  • Sexually active young adults
  • Treatment: Ceftriaxone or cefotaxime
• Rods:
  • E. coli, Pseudomonas, Serratia
  • Risk factors: IVDU, GI infection, immunosuppression, trauma, elderly
  • Treatment: Cefepime or piperacillin/tazobactam + antipseudomonal aminoglycoside in IVDU