Septic arthritis and Acute osteomyelitis

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Surgical drainage is recommended in all cases presenting with a greater than 24 hours history.

	Medicine	Adult Dose	Frequency	Duration
	cloxacillin iv	1-2g	4 times a day	4-6 week
or	clindamycin iv	600mg	3 times a day	4-6 weeks

Culture and sensitivity should guide antibiotic choice where available. Erythrocyte Sedimentation Rate (ESR) is useful in monitoring response. Duration of therapy may be reduced if fever and toxicity have resolved, and if X-ray is normal. Switch to oral therapy when a good response is achieved.

Chronic osteomyelitis

Surgery is recommended. Antibiotics alone are not generally recommended.