Tratamiento de la artritis bacteriana

Bacterial arthritis is a medical emergency, in which a delay in treatment results in a significant mortality (10-15%) and morbidity (25-50%). Diagnostic suspicion and early start of treatment are mandatory to maintain normal articular function. The initial choice of antibiotic should be guided by Gram's stain of sinovial fluid. When no organisms are seen on Gram's stain, the antimicrobial regimen should be based on the patients age and the clinical setting. The possibility of a multiresistant microorganism should also be considered. An important aspect of treatment of bacterial arthritis is drainage of purulent synovial fluid and joint irrigation. Whether daily percutaneous needle aspiration or surgical drainage by arthroscopy is performed is a matter of debate. No randomised controlled studies exist that compare these two approaches. Early rehabilitation exercises are recommended to achieve maximum articular function.