Abstract
Septic arthritis carries significant morbidity and mortality, necessitating prompt, appropriate therapy with joint fluid aspiration, intravenous antibiotics, and occasionally, surgical intervention. The initial choice of antimicrobial agent is guided by the results of synovial fluid gram stain, by identification of the pathogenesis of the primary focus, or by epidemiologic factors. Adequacy of therapy is assessed by serial synovial fluid white blood cell counts and by determining antimicrobial concentrations in the joint space. The goal of treatment is a clinically normal and sterile joint. Factors that may affect antimicrobial joint penetration include the degree of joint tissue inflammation, the degree of drug protein binding, and the chemical characteristics of the drug. Perhaps most important in determining the extent of joint penetration are factors that may affect serum antibiotic concentrations, for example, dose, route of administration, volume of distribution, but rate of elimination.
References
Mar 1, 1977·The Medical Clinics of North America·J R Ward, S G Atcheson
Jan 1, 1979·Infection·D S Reeves, P J Wilkinson
Nov 1, 1979·The Journal of Antimicrobial Chemotherapy·P J Wilkinson, D S Reeves
Jan 1, 1978·The Journal of Pediatrics·J D NelsonS Shelton
Jan 1, 1978·The Journal of Pediatrics·T R TetzlaffJ Larrondo
May 1, 1978·The Journal of Infectious Diseases·L R Levine, E McCain
Nov 1, 1978·Antimicrobial Agents and Chemotherapy·R H FitzgeraldJ A Washington
Mar 1, 1976·The American Journal of Medicine·D L Goldenberg, A S Cohen
Oct 1, 1977·Antimicrobial Agents and Chemotherapy·T H Dee, F Kozin
Jan 1, 1975·Arthritis and Rheumatism·D L GoldenbergE S Cathcart
Oct 1, 1975·Postgraduate Medicine·J R Ward
Sep 1, 1974·Arthritis and Rheumatism·K D BrandtA S Cohen
Sep 1, 1971·Clinical Pharmacology and Therapeutics·E A Baciocco, R L Iles
Aug 17, 1974·British Medical Journal·J H Newman
Jan 1, 1972·Current Medical Research and Opinion·S D DeodharW W Buchanan
Oct 1, 1969·Arthritis and Rheumatism·F R Schmid, R H Parker
Jan 1, 1972·Annals of the Rheumatic Diseases·A S Russell, B M Ansell
Sep 1, 1972·Clinical Pharmacology and Therapeutics·A HowellG N Rolinson
Jul 15, 1971·The New England Journal of Medicine·A ChowR Winters
Feb 18, 1971·The New England Journal of Medicine·J D Nelson
Jan 1, 1971·Arthritis and Rheumatism·R H Parker, F R Schmid
Aug 1, 1980·Arthritis and Rheumatism·J RosenthalW D Robinson
Sep 1, 1960·Archives of Internal Medicine·R F WILLKENSJ L DECKER