Septic Arthritis

Septic Arthritis

Routine Practices

  • Obtain blood cultures, CRP, ESR prior to starting antibiotics
  • Must tap joint for therapeutic purposes, prior to antibiotics if patient stable; send sample for culture
  • MRI of affected area
  • Recommend ID consult if not responding to treatment, delayed presentation, chronic or recurrent osteomyelitis, associated wound or abscess, unusual organism, foreign body (e.g., orthopedic hardware)
  • Consult ID if chronic or complicated septic arthritis

Common Pathogens

Duration of Therapy

Acute uncomplicated septic arthritis: 2-3 weeks

  • Switch to oral antibiotics after 2-4 days if clinically improved (no fever, using limb, CRP/ESR trending down)
  • If bacteremic, may switch to oral antibiotics after 4-7 days if improving and uncomplicated course

More Information

Lancet Infect Dis 2016; 16: e139–52