What to know about antibiotics for septic arthritis

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Antibiotics are a type of medication that healthcare professionals may prescribe to treat bacterial infections.

Just as several different types of bacteria can make a person sick, there are various antibiotics a doctor can use that may be more effective against certain types of bacteria.

These medications either cause the bacteria to slow their growth and reproduction rate or directly kill the bacteria. They do not affect viral or fungal infections, such as a cold, most types of sore throat, and many other types of infection.

Side effects

Though most people can safely take antibiotics, they can cause a range of side effects, including:

• diarrhea
• rashes
• nausea
• yeast infections

More serious side effects may include:

• a Clostridioides difficile infection
• severe, potentially life threatening allergic reactions
• antibiotic-resistant infections

A person should speak with a healthcare professional if they experience side effects while taking antibiotics.

The exact antibiotics a doctor recommends to treat septic arthritis will vary based primarily on the underlying infection. Viral and fungal causes will not require or benefit from antibiotic treatment.

In most cases, a person will receive about 2 weeks of IV antibiotics. Following this, they will continue to take oral antibiotics for 1–2 weeks, depending on a doctor’s instructions.

Some infections may require an additional 4–6 weeks of oral antibiotics. This is the case with Pseudomonas aeruginosa.

A type of septic arthritis called Gonococcal arthritis often responds well to ceftriaxone. Doctors typically continue intravenous delivery for 24–48 hours following an improvement in symptoms. At that point, they usually continue treatment with oral antibiotics.

A doctor will typically closely monitor the progress of treatment with antibiotics. If the joint shows no sign of improvement after about 5–6 days, they may need to reassess the underlying cause. They will likely check for the presence of Lyme disease.

Usually, a doctor will start a broad-spectrum antibiotic treatment to manage the infection. After cultures return from the lab, a doctor will likely change the treatment to target specific bacteria. Common antibiotics a healthcare professional may recommend include:

• nafcillin
• oxacillin
• vancomycin

A doctor may recommend vancomycin for Gram-positive bacteria, which includes any strains of bacteria that appear in a Gram stain test.

For Gram-negative bacteria, a healthcare professional may recommend cephalosporin antibiotics. They may also recommend this type of antibiotic for people with compromised immune systems or who regularly inject themselves with needles.

Examples of cephalosporins include:

• ceftriaxone
• ceftazidime
• cefotaxime

Septic arthritis has two main treatments: antibiotics in IV form followed by oral form and draining of the affected joint.

Drainage of the joint helps relieve pressure, reduces symptoms, and helps prevent damage. Methods include:

• Joint aspiration: This is the least invasive method to drain the joint. A healthcare professional inserts a needle into the joint during this procedure and removes some of the fluid.
• Arthroscopy: In this procedure, a surgeon makes a small incision in the skin and inserts a roughly pencil-sized instrument inside to observe the joint. They can drain the fluid during this procedure.
• Open joint surgery: A doctor may also recommend this option. In cases of infected joint replacements, a surgeon will need to remove the prosthetic joint and replace it with antibiotic-infused cement.

A person will likely need physical therapy following treatment. This will help restore flexibility and movement to the joint.

Septic arthritis starts suddenly in most cases.

A person should speak with a doctor if they or a child in their care suddenly develops any of the following in a joint:

• swelling
• pain
• loss of mobility

Rapid identification and treatment are important to restore joint function and prevent permanent damage to the joint.

A doctor will typically closely monitor a person undergoing antibiotic treatment for septic arthritis. They will use the characteristics of the particular strain and other factors to determine the best course of treatment.

If the first option they choose does not help relieve symptoms, they may need to try different antibiotics, additional testing, or draining the joint.

Septic arthritis is often the result of a bacterial infection, which means most cases will respond well to antibiotics. This can involve a combination of IV and oral treatments, which can last 2–8 weeks.

Different antibiotics target different types of bacteria. A doctor will choose the best antibiotic for the type of infection a person has and based on how well their symptoms respond to treatment. Antibiotics will not work if the infection is due to a virus or fungus.

All cases of septic arthritis may require a doctor or surgeon to drain the joint. The person will also likely need physical therapy to restore function to the joint.

People should speak with a healthcare professional if they experience any symptoms of septic arthritis or side effects while taking antibiotics.