Septic Arthritis (No Hardware in Place)

Diagnosis Common Pathogens Drug(s) of First Choice Alternative Drug(s) Comments Expected Duration

Septic Arthritis (no hardware in place)

S. aureus
Streptococcus spp.
N. gonorrhoeae
Enterobacteriaceae
(rarely)

Vancomycin
PLUS
Ceftriaxone 2g IV daily if at risk for gonococcus or GNR (IDU, immunocompromised, elderly) or Gram stain shows gram-negative organisms

For severe PCN allergy:
Vancomycin
PLUS:
Aztreonam
If N. gonorrhoeae suspected, please consult ID or ID pharmacy for alternate treatment recommendations

Gram stain recommended to guide therapy

Narrow coverage to microbiologically confirmed pathogens.

ID consultation recommended