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GOI Antibiotic Guideline For Bones And Joint Infections

GOI Antibiotic Guideline For Bones And Joint Infections

In 2016, National Centre For Disease Control, Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India came out with National Treatment Guidelines for Antimicrobial Use in Infectious Diseases.

Following are major recommendation

Bones And Joint Infections :

Condition Likely causative Organisms Empiric antibiotics Alternative antibiotics Comments
Acute osteomyelitis OR Septic arthritis S.aureus, Streptococcus pyogenes Enterobacteriaceae Ceftriaxone 2g IV OD Followed by Oral therapy by Cloxacillin 500mg q 8h


Cephalexin 500mg q 6h

Piperacillintazobactam 4.5gm IV q 6h or Cefoperazonesulbactam 3gm IV q 12h


Clindamycin 600- 900mg IV TDS

Treat based on culture of blood/synovial fluid/bone biopsy

Orthopedic Consultation is essential for surgical debridement

Duration: 4-6 weeks (From initiation or last major debridement)

Chronic Osteomyelitis OR Chronic synovitis No empiric therapy Definitive treatmentguided by bone/synovial biopsy culture.

Treat for 6 weeks minimum

Investigate for TB, Nocardia, fungi. Extensive surgical debridement.

Total duration of treatment depends on the joint and the organism. Choose antibiotic based on sensitivity.

Prosthetic joint infection Coagulase negative staphylococci, Staphylococcus aureus,Streptococci Gram-negative bacilli, Enterococcus, Anaerobes Ceftriaxone 2g IV OD. Add Vancomycin1gm IV BD or Teicoplanin 800mg x 3 doses followed by 400mg Once daily 4 weeks

You can read the full Guideline by clicking on the following link :

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