Spectrum: Local Antimicrobial Stewardship, for CHEO-OCTC

Osteomyelitis/Septic Arthritis

Note

ID consult is recommended.

Infection Prevention and Control

If Haemophilus influenza type b suspected:

Droplet Precautions

In non immune child < 5 years of age, maintain precautions until 24 hours of appropriate antimicrobial therapy received

If Haemophilus influenza type b is not suspected, use Routine Practices

Most Likely Pathogens

S. aureus (MSSA)

Kingella kingae (most common in children < 2 years old)

S. pyogenes (GAS) (less common)

Empiric Antimicrobials

CeFAZolin IV

If Cultures Positive for MSSA

Cloxacillin IV

If Cultures Positive for GAS

Penicillin IV

Usual Duration

3 - 4 weeks for osteomyelitis including conversion to PO when appropriate

3 - 4 weeks recommended for septic arthritis.

Most clinicians recommend 4 - 6 weeks for hip septic arthritis

Consult ID