NHS Dumfries & Galloway Antimicrobial Handbook
Take blood cultures AND consult orthopaedics for samples, ideally prior to antibiotics.
First line 0 - 5 years old
IV cefUROXime
Oral switch: co-amoxiclav
First line 6+ years OLDIV flucloxacillin
Oral switch: flucloxacillin (capsules) or co-amoxiclav (liquid)
Haemophilus influenzae B (Hib) vaccination incomplete: IV/PO co-amoxiclav
Penicillin allergy All agesIV co-trimoxazole
Oral switch: co-trimoxazole
TOTAL duration (IV + PO)
- Unifocal disease:
- "Simple" disease at a single site
- IV to PO switch: afebrile, pain free >24 hours, CRP <20 or reduced by 2/3 highest value
- Duration:
- septic arthritis: 3 weeks
- osteomyelitis: 4-6 weeks
- liaise with Microbiology Consultant / Orthopaedics
- Complex disease:
- Includes multifocal, significant bone destruction, resistant or unusual pathogen, immunosuppression, sepsis or shock or associated with metal work
- IV to PO switch: after 14 days
- Duration:
- may require 6+ weeks of treatment
- liaise with Microbiology / Consultant Orthopaedics