Septic Arthritis Treatment Drugs

Definition

The term "septic arthritis" refers to severe inflammation, acute or chronic, of an infectious nature, triggered by bacteria (above all), viruses and fungi; more precisely, to cause septic arthritis, the pathogens must invade the synovial membrane, giving rise to an inflammatory process which is characterized by the formation of purulent exudate (filled with pus) inside the joint space.

Causes

Bacteria are the etiopathological factors most responsible for septic arthritis, in particular Staphylococcus aureus (commensal bacterium normally found in the skin and nose) Streptococcus spp., Borrelia burgdorferi, Brucella burgdorferi and Neisseria gonorrhoeae. In addition to bacteria, fungi (e.g. C. albicans) and some viruses (e.g. HBV, HIV 1, Parvovirus B19) can cause similar harm.

Risk factors: AIDS, rheumatoid arthritis, osteoarthritis, catheterization, diabetes, hemophilia, bacterial endocarditis, prosthetic implantation, lupus, drug addiction

Symptoms

In the context of septic arthritis, pain in the affected joint, often sudden and acute, is an almost constant element; in addition to pain, which is accentuated with movement, the patient often complains of high fever, joint swelling, loss of appetite, irritability, acute synovitis, vasculitis, limited burning sensation, tachycardia (in the child).

Complications: permanent functional impotence or inability to move the limb (25-50% of cases), death (5-10% of cases)

The information on Septic Arthritis - Drugs to Treat Septic Arthritis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Septic Arthritis - Drugs to Treat Septic Arthritis .

Medicines

To increase the chances of a good prognosis, and therefore of survival of the patient without complications, it is essential to start pharmacological therapy for septic arthritis no later than 7 days from the onset of the very first symptoms: we remind you again that starting therapy in a short time minimizes the risk of suffering irreversible injuries.
After the diagnostic investigation and the ascertainment of the pathogen involved in septic arthritis, it is possible to proceed with the administration of antibiotic drugs. At first, if the diagnosis of septic arthritis has been ascertained but the pathogen has not yet been isolated, it is possible to administer broad-spectrum antibiotics to the patient, therefore active against a range of rather large pathogens: in general, antibiotics are used that can determine a good therapeutic action towards S.. aureus and Streptococcus spp., since most septic arthritis depends on these pathogens.
In any case, after the certain identification of the pathogen, it is advisable to modify the therapy, choosing a more specific drug. The antibiotic drugs are first administered intravenously (for three weeks); subsequently, the treatment can be converted into oral therapy (to be followed for another 2-4 weeks).
The antibiotic drugs most used in therapy are penicillins, gentamicin (possibly in combination with other antibiotics) and the latest generation cephalosporins; not to forget, however, that bacteria can develop resistance to drugs, so the therapy may be ineffective.
If the therapy described above is not sufficient to reverse the pathology, a drainage of the accumulated purulent material is conceivable. In turn, drainage can be carried out in two ways:

Needle aspiration: first choice treatment, usable for all joints, except for the hip and shoulder.
Surgical drainage: in the case of septic arthritis reaching the level of the axial joints

The following are the classes of drugs most used in therapy for the treatment of septic arthritis, and some examples of pharmacological specialties: it is up to the doctor to choose the active ingredient and the dosage most suitable for the patient, based on the triggering cause, the severity of the disease, and the patient's response to treatment:

Benzylpenicillin (eg. Benzyl B, Penicillin G): indicated above all for the treatment of gonococcal-dependent septic arthritis. Start therapy by taking the drug intravenously at a dose of 10 million units per day: proceed in this way for three weeks After this period, it is possible to take the drug orally, and the intra-articular administration of the drug did not lead to any advantage.
Oxacillin (eg. Penstapho): the drug (semi-synthetic penicillin resistant to beta-lactamases) is prescribed for the treatment of gram-positive septic arthritis; the dosage suggests administering the drug at a dose of 2 grams, intravenously, every 4 hours The duration of therapy must be established by the doctor.
As an alternative to this drug, take clindamycin (eg Dalacin-T, Clindamycin BIN, Zindaclin, Dalacin-C), at a dose of 900 mg, i.v., every 8 hours. In case of allergy to beta lactam antibiotic drugs, it is recommended to take vancomycin.
Vancomycin (eg. Vancocin, Zengac, Maxivanil): glycopeptide antibiotic indicated for the treatment of septic arthritis due to methicillin-resistant staphylococcus (methicillin is another antibiotic); the chances of developing drug resistance increase in case of immunocompromised or drug addiction. The drug is generally taken at a dose of 30 mg / kg per day, intravenously, possibly dividing the load into 4 doses or by continuous infusion.
Ceftriaxone (eg. Ceftriaxone, Pantoxon, Ragex, Deixim): third generation cephalosporin. It is recommended to take the drug at a dose of 1 gram intravenously, for 7-10 days. Indicated for the treatment of gram negative septic arthritis.
Cefotaxime (eg. Cefotaxime, Aximad, Lirgosin - third generation cephalosporin) or cefuroxin (eg. Cefoprim, Tilexim, Zoref, Zinnat): these two drugs are two valid alternatives to cefatrixone. The dose for the treatment of gonococcal septic arthritis suggests taking 1 gram of active intravenously, three times a day, for only 2-3 days. After this time, it is recommended to take 400 mg of cefixime ( eg. Cefixoral, Suprax, Unixime: third generation cephalosporin), orally, twice a day or ciprofloxacin (eg. Ciprofloxac, Samper, Ciproxin, Kinox) at a dose of 400-500 mg, 2 times a day, always for mouth.

In general, antibiotic therapy should be continued for two weeks in septic arthritis streptococci, H. influenzae and gram negative cocci (spherical pathogens); when staphylococci or gram-nagative bacilli (cylindrical pathogens) are the main causes of septic arthritis, therapy with antibiotic drugs should be continued for at least three weeks.