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Acute native osteomyelitis or septic arthritis
Please read the following guidance for patients with Myasthenia gravis 
First Line
Second Line
​​​Allergy status
(Confirm allergy status prior to choosing antimicrobial regime)
No penicillin allergy
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Check for interactions
Gentamicin STAT
(If systemic upset due to sepsis)
Gentamicin STAT
(If systemic upset due to sepsis)
Flucloxacillin 2g every 6 hours
Gentamicin 5mg/kg STAT
(Dose and frequency according to calculator – maximum 450mg in 24 hours)
Teicoplanin loading dose = 12mg/kg every 12 hours for 2 days
(see guidelines for maintenance dose)​
Gentamicin 5mg/kg STAT
(Dose and frequency according to calculator – maximum 450mg in 24 hours)
Review with culture and sensitivity results.
Gentamicin should usually be discontinued after intial STAT dose if signs of improvement and no alternative focus of infection identified



Additional Information:
  • Withhold antibiotics pending appropriate microbiological sampling (e.g. synovial fluid aspirate [except in severe sepsis], blood cultures [all cases]).
  • In cases of possible septic arthritis, refer to local guidance for management of the “hot joint”

Duration of antibiotic therapy:

  • Orthopaedic infections are usually treated for 6 weeks from the time of definitive surgery.
  • It may be reasonable to convert antibiotics from intravenous to oral administration within that time however, depending upon patient factors, the bacterial pathogen and the availability of agents with good oral bioavailability for treating it. 
  • Treatment durations of greater than 6 weeks may be considered in certain circumstances, but should be agreed on a case-by-case basis through the MDT