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 :