Post-operative
- All require surgical debridement for therapy and C&S of bone.
- Hardware should be removed if possible. If not possible, consider adding rifampin if S. aureus/MRSA.
- Hold antibiotics until cultures are obtained unless the child is unwell or no debridement is planned.
Usual Pathogens
S. aureus/MRSA
Group A Streptococci
Occasionally:
Enterobacterales
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cefazolin | 100mg/kg/d IV div q8h | 6 weeks |
| +/- | ||
| Gentamicin | 7mg/kg IV q24h |
MRSA colonized or high endemic rate
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Vancomycin | 60mg/kg/d IV div q6h | 6 weeks |
| +/- | ||
| Gentamicin | 7mg/kg IV q24h |