Pharmacokinetic Optimisation of the Treatment of Septic Arthritis

Hamed, Kamal; Tam, Janice Y.; Prober, Charles G.

doi:10.2165/00003088-199631020-00006

Cited by 29 publications

(7 citation statements)

References 23 publications

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“…3 A dilemma arises when the clinical features suggest SA but bacteria cannot be identified within the joint because justification for aggressive treatment and prolonged inpatient stay is required. As far as we know, this is the first study to compare patients with SA in whom bacteria can be identified with those in whom the clinical characteristics are suggestive of SA but in whom the SF culture is sterile.…”

Section: Discussionmentioning

confidence: 99%

Prospective comparative study of patients with culture proven and high suspicion of adult onset septic arthritis

Gupta

Sturrock²,

Field³

2003

Annals of the Rheumatic Diseases

133

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Objective: To investigate whether patients with acute septic arthritis (SA) diagnosed by positive synovial fluid (SF) culture (Newman grade A) have different clinical and serological features from those with sterile SF in whom there is nonetheless a high suspicion of SA (Newman grades B and C). Patients and methods: A prospective 12 month multicentre hospital based study of adult patients with SA recruited 47 patients with culture positive SA and 35 patients with clinically suspected SA but sterile SF. Results: Patient demography, clinical and laboratory features at presentation were similar irrespective of the underlying diagnosis, SF culture, and the presence of prosthetic joints. Medical and surgical treatment and outcome were comparable in the two patient groups. Patients with both suspected and proven SA were more likely to be from the more socially deprived areas of our community (p<0.0001). Conclusion: Patients in whom there is a high clinical suspicion of SA are comparable to those patients with SA with a positive SF culture and have similar morbidity and mortality on follow up. Therefore, if clinical suspicion of SA is high then it is correct to treat as SA in the absence of bacterial proof.

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Section: Discussionmentioning

confidence: 99%

Prospective comparative study of patients with culture proven and high suspicion of adult onset septic arthritis

Gupta

Sturrock²,

Field³

2003

Annals of the Rheumatic Diseases

133

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“…38 Most authors agree that antibiotics should be given parenterally initially and then orally once the signs and symptoms of infection start to resolve. 3,4,[39][40][41] The recommended duration of antibacterial treatment varies from two weeks to more than three months although most authors favour six weeks. 23,42 The method of drainage of a septic joint remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Septic arthritis of the shoulder in children in malawi: A randomised, prospective study of aspiration versus arthrotomy and washout

Smith¹,

Thyoka²,

Lavy³

et al. 2002

The Journal of Bone and Joint Surgery

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We undertook a prospective study of 61 children in Malawi with septic arthritis of the shoulder. They were randomised into two groups, treated by aspiration (group 1, 31 patients) or arthrotomy (group 2, 30 patients). Both received antibiotics for six weeks. We studied the results of blood tests, microbiology, and the clinical and radiological outcome one year after diagnosis. Only one patient was sickle-cell positive and three were HIV-positive. Non-typhoidal Salmonella species accounted for 86% (19/22) of the positive joint cultures in group 1 and 73% (16/22) in group 2. Of the 33 radiographs available for review at follow-up at six months, 23 (70%) showed evidence of glenohumeral damage. There was no statistical difference in radiological outcome for the two groups. We devised and validated a scoring system, the Blantyre Septic Joint Score, for the assessment of joints based upon swelling, tenderness, function and range of movement. Despite the radiological changes only one of the 24 joints examined at one year had any deficit in these parameters. There was no statistical difference in the clinical outcome for the two treatment groups at any stage during the period of follow-up.

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“…However, this invasive procedure is very difficult to repeat on the same diabetic patient who often has recurrent foot ulceration. In arthritis, needle puncture is commonly used to determine the causal bacteria and to adjust antibiotic treatment [6]. As this procedure is safe, it could also be useful for the microbiological analysis of bone infection in diabetic patients with foot ulceration.…”

Section: Introductionmentioning

confidence: 99%

Comparison of microbiological results of needle puncture vs. superficial swab in infected diabetic foot ulcer with osteomyelitis

Kessler¹,

Piémont²,

Ortega³

et al. 2005

Diabetic Medicine

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Pharmacokinetic Optimisation of the Treatment of Septic Arthritis

Cited by 29 publications

References 23 publications

Prospective comparative study of patients with culture proven and high suspicion of adult onset septic arthritis

Prospective comparative study of patients with culture proven and high suspicion of adult onset septic arthritis

Septic arthritis of the shoulder in children in malawi: A randomised, prospective study of aspiration versus arthrotomy and washout

Comparison of microbiological results of needle puncture vs. superficial swab in infected diabetic foot ulcer with osteomyelitis

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