How is arthritis treated in patients with Haemophilus influenzae infections?

Updated: Jul 02, 2019
  • Author: Joseph Adrian L Buensalido, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

A short course of intravenous antibacterial therapy followed by an oral agent for 2-3 weeks is considered safe and effective in uncomplicated cases. However, intravenous antimicrobial treatment should be given for at least 3 weeks if the septic arthritis is more complicated. [83]

Therapy may continue beyond 3 weeks until the ESR begins to normalize. The ESR may lag behind successful clinical response for weeks; accordingly, the C-reactive protein test may be a more useful laboratory tool because its values tend to normalize more rapidly.

Evidence has shown that high doses of well-absorbed antibacterials for 10 days (given intravenously for a only a couple of days) appear noninferior to 30 days of treatment for childhood septic arthritis, but only if the patient responds well clinically and the CRP level promptly normalizes. [84] Because of this, attempting a short course of therapy (10 days) has been recommended (1) if the patient (or parent) will be compliant and amenable to close clinical, laboratory, and radiographic follow-up and (2) if the patient (or parent) is willing to prolong the antimicrobial course for more than 10 days if symptoms and CRP levels persist. If any of the above conditions are in question, the longer treatment course is prudent to reduce the likelihood of treatment failure (around 10%, which can seriously affect the patient's quality of life). [85]


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