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Treatments and drugs
By Mayo Clinic staffDoctors rely on antibiotic drugs and joint drainage when treating septic arthritis.
Antibiotic drugs
Your doctor must identify the bacterium that's causing your infection, and then select the most effective antibiotic to target that specific bacterium. Antibiotics are usually given through a vein in your arm (intravenously) at first. Later, in some cases, you may be able to switch to oral antibiotics. How long you undergo antibiotic treatment depends on your health, the type of bacterium you're infected with and the extent of the infection. Typically, treatment lasts about two to six weeks.
Antibiotics carry a risk of side effects, including nausea, vomiting and diarrhea. Allergic reactions also can occur. Talk to your doctor about the side effects to expect from your specific medication.
Joint drainage
Draining the infected synovial fluid from your joint serves three purposes: It removes bacteria from your joint, reduces pressure on your joint, and gives your doctor a sample to test for bacteria and other organisms. The most common method of removing joint fluid is through arthroscopy (ahr-THROS-skuh-pee). In arthroscopy, a flexible tube with a video camera at its tip is placed in your joint through a small incision. Suction and drainage tubes are then inserted through small incisions around your joint to siphon off infected synovial fluid.
Your doctor may be able to remove fluid from your joint with a needle (arthrocentesis). Arthrocentesis may be repeated, usually daily, until no bacteria are found in the extracted fluid. Hip joints, which are difficult to access, may require open surgery for fluid drainage. Repeat surgery is sometimes necessary.
Recovery
Once the infection is under control, your doctor may recommend gentle movement to keep your joint functional. Motion can keep your joint from becoming stiff and your muscles from becoming weak. Movement also encourages blood flow and circulation, which helps your body's healing process.
- George HO, et al. Bacterial arthritis. In: Firestein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: W.B. Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/202388075-9/0/1807/746.html?tocnode=55734150&fromURL=746.html#4-u1.0-B978-1-4160-3285-4..10099-3_3613. Accessed May 30, 2010.
- Garcia-De LaTorre I, et al. Gonococcal and nongonococcal arthritis. Rheumatic Disease Clinics of North America. 2009;35:63.
- Zinc BJ, et al. Bone and joint infections. In: Marx JA, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo.:Mosby;2006. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-323-05472-0..00134-1--s0180&uniq=202388075&isbn=978-0-323-05472-0&sid=1002434146#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-0-323-05472-0..00134-1--s0110%3Bfrom%3Dtoc%3Btype%3DbookPage%3Bisbn%3D978-0-323-05472-0. Accessed May 30, 2010.
- Ohl CA. Infectious arthritis of native joints. In: Mandell GL, et al. Mandell, Bennett, & Dolin: Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2005. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-0-443-06839-3..00102-8&displayedEid=4-u1.0-B978-0-443-06839-3..00102-8--s0015&uniq=202388075&isbn=978-0-443-06839-3&sid=1002438834. Accessed May 30, 2010.
- Goldenberg DL. Septic arthritis in adults. http://www.uptodate.com/home/index.html. Accessed May 30, 2010.
- Krogstad P. Bacterial arthritis: Clinical features and diagnosis in infants and children. http://www.uptodate.com/home/index.html. Accessed May 30, 2010.
- Steckelberg JM (expert opinion). Mayo Clinic, Rochester, Minn. June 3, 2010.
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