What is the treatment protocol for septic arthritis in children older than 3 months?

The treatment protocol for septic arthritis in children older than 3 months typically involves the use of antibiotics that provide adequate coverage for the most common pathogens, including Staphylococcus aureus, Streptococcus species, and, in certain populations, gram-negative bacteria.

The combination of clindamycin and cefazolin is effective because clindamycin offers excellent coverage against anaerobes and certain strains of Staphylococcus, including methicillin-sensitive strains, while cefazolin is a first-generation cephalosporin that is effective against many gram-positive organisms, particularly those associated with skin and soft tissue infections. This combination helps to ensure broad coverage against the pathogens commonly encountered in septic arthritis cases.

Selecting an appropriate combination antibiotic therapy is crucial in pediatric patients, especially considering the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and the need to address both gram-positive and possible gram-negative organisms.

While other antibiotic regimens may target certain organisms, they may not provide the comprehensive coverage necessary for the common bacteria causing septic arthritis in this age group. Thus, the choice of clindamycin and cefazolin stands out for its broad-spectrum efficacy in this clinical scenario.