Sandbox ID Musculoskeletal

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Bursitis

  • Olecranon bursitis or prepatellar bursitis [1]
  • 1. Staphylococcus aureus, methicillin-susceptible (MSSA)
  • 2. Staphylococcus aureus, methicillin-resistant (MRSA)
  • Preferred regimen (2): Linezolid 600 mg PO qd

Osteomyelitis, candidal

  • Osteomyelitis, candidal [2]
  • Preferred regimen (1): Fluconazole 400 mg/day (6 mg/kg/day) PO for 6–12 months
  • Alternative regimen (2): Caspofungin 70mg loading dose THEN 50 mg/day PO
  • Alternative regimen (3): Micafungin 100 mg/day PO
  • Alternative regimen (4): Amphotericin B deoxycholate 0.5–1 mg/kg/day PO for several weeks THEN Fluconazole for 6–12 months
  • Note: Duration of therapy usually is prolonged (6–12 months); Surgical debridement is frequently necessary

Osteomyelitis, chronic

  • 1. Chronic Osteomyelitis in Adults – Pathogen-Based Therapy [3]
  • 1.1 OSSA
  • Preferred regimen (1): Oxacillin 1.5–2 g IV q4h for 4–6 weeks
  • Preferred regimen (2): Cefazolin 1–2 g IV q8h for 4–6 weeks
  • Alternative regimen (1): Vancomycin 15 mg/kg IV q12h for 4–6 weeks
  • Alternative regimen (2): Oxacillin 1.5–2 g IV q4h for 4–6 weeks AND Rifampin 600 mg PO qd
  • 1.2 ORSA
  • Preferred regimen (1): Vancomycin 15 mg/kg IV q12h for 4–6 weeks
  • Preferred regimen (2): Daptomycin 6 mg/kg IV q24h
  • Alternative regimen (1): Linezolid 600 mg PO/IV q12h for 6 weeks ± Rifampin 600–900 mg PO qd
  • Alternative regimen (2): Levofloxacin 500–750 mg/day PO/IV ± Rifampin 600–900 mg PO qd
  • 1.3 Penicillin-sensitive Streptococcus
  • Preferred regimen (1): Penicillin G 20 MU/day IV continuously or q4h for 4–6 weeks
  • Preferred regimen (2): Ceftriaxone 1–2 g IV/IM q24h for 4–6 weeks
  • Preferred regimen (3): Cefazolin 1–2 g IV q8h for 4–6 weeks
  • Alternative regimen: Vancomycin 15 mg/kg IV q12h for 4–6 weeks
  • 1.4 Enterococcus or Streptococcus (MIC≥ 0.5 μg/mL) or Abiotrophia or Granulicatella
  • Preferred regimen (1): Penicillin G 20 MU/day IV continuously or q4h for 4–6 weeks ± Gentamicin 1 mg/kg IV/IM q8h for 1–2 weeks
  • Preferred regimen (2): Ampicillin 12 g/day IV continuously or q4h for 4–6 weeks ± Gentamicin 1 mg/kg IV/IM q8h for 1–2 weeks
  • Alternative regimen: Vancomycin 15 mg/kg IV q12h for 4–6 weeks ± Gentamicin 1 mg/kg IV/IM q8h for 1–2 weeks
  • 1.5 Enterobacteriaceae
  • Preferred regimen (1): Ceftriaxone 1–2 g IV/IM q24h for 4–6 weeks
  • Alternative regimen (2): Ciprofloxacin 500–750 mg PO bid for 4–6 weeks
  • 1.6 Pseudomonas aeruginosa
  • Preferred regimen (1): Cefepime 2 g IV q12h
  • Preferred regimen (3): Imipenem 500 mg IV q6h for 4–6 weeks
  • Alternative regimen (1): Ciprofloxacin 750 mg PO q12h
  • Alternative regimen (2): Ceftazidime 2 g IV q8h for 4–6 weeks
  • 2. Chronic Osteomyelitis in Children – Pathogen-Based Therapy
  • Group A beta-hemolytic Streptococcus, Haemophilus influenzae type B and Streptococcus pneumoniae
  • Preferred regimen (1): Ampicillin 150–200 mg/kg/day q6h

Osteomyelitis, contiguous with vascular insufficiency

  • Osteomyelitis, contiguous with vascular insufficiency [4]
  • Debride overlying ulcer and send bone specimen for histology and culture.
  • No empiric antimicrobial therapy unless acutely ill.
  • Antibiotic therapy should be based on culture results and treat for 6 weeks.
  • Revascularize if possible.

Osteomyelitis, diabetic foot

  • 1. Chronic Infection or Recent Antibiotic Use [5]
  • Preferred regimen (2): Cefoxitin 1 g IV q4h (or 2 g IV q6–8h)
  • Preferred regimen (3): Ceftriaxone 1–2 g/day IV/IM q12–24h
  • Preferred regimen (6): Ertapenem 1 g IV/IM q24h
  • Preferred regimen (7): Tigecycline 100 mg IV THEN 50 mg IV q12h (active against MRSA)
  • Preferred regimen (8): Imipenem-Cilastatin 0.5–1 g IV q6–8h (Not active against MRSA; consider when ESBL-producing pathogens suspected)
  • Alternative regimen (1): Levofloxacin 750 mg IV/PO q24h AND Clindamycin 150–300 mg PO qid
  • Alternative regimen (2): Ciprofloxacin 600–1200 mg/day IV q6–12h AND Clindamycin 150–300 mg PO qid
  • Alternative regimen (3): Ciprofloxacin 1200–2700 mg IV q6–12h (for more severe cases) AND Clindamycin 150–300 mg PO qid
  • 2. High Risk for MRSA
  • Preferred regimen (1): Linezolid 600 mg IV/PO q12h
  • Preferred regimen (3): Vancomycin 15–20 mg/kg IV q8–12h (trough: 10–20 mg/L)
  • 3. High Risk for Pseudomonas aeruginosa
  • 4. Polymicrobial Infection

Osteomyelitis, foot bone

  • Foot bone osteomyelitis due to nail through tennis shoe [6]
  • Alternative regimen (2): Cefepime 2 g IV q12h

Osteomyelitis, foot puncture wound

  • Long bone, post-internal fixation of fracture [7]
  • 1. S. aureus or P. aeruginosa
  • 2. Gm-neg. bacilli

Osteomyelitis, hematogenous

  • 1. Empiric therapy [8]
  • 1.1 Adult (>21 yrs)
  • 1.1.1 MRSA possible
  • Preferred regimen: Vancomycin 1 g IV q12h (if over 100 kg, 1.5 g IV q12h)
  • 1.1.2 MRSA unlikely
  • 1.2 Children (>4 mos.)-Adult
  • 1.2.1 MRSA possible
  • 1.2.2 MRSA unlikely
  • 1.3 Newborn (<4 mos.)
  • 1.3.1 MRSA possible
  • 1.3.2 MRSA unlikely
  • 2. Specific therapy
  • 2.1 MSSA
  • 2.2 MRSA

Osteomyelitis, hemoglobinopathy

  • Osteomyelitis, hemoglobinopathy [9]

Osteomyelitis, spinal implant

  • Culture, treat & then suppress until fusion occurs
  • Main parenteral antimicrobial therapy
  • Suppressive antimicrobial therapy strategy
  • 2. Onset after 30 days
  • Remove implant, culture & treat
  • Main parenteral antimicrobial therapy
  • Suppressive antimicrobial therapy strategy

Osteomyelitis, vertebral

  • Vertebral Osteomyelitis – Pathogen-Based Therapy [12] [13]
  • 1. OSSA or coagulase-negative staphylococci
  • 2. ORSA
  • 3. Streptococcus
  • 4. Enterobacteriaceae, quinolone-susceptible
  • 5. Enterobacteriaceae, quinolone-resistant
  • Preferred regimen: Imipenem 500 mg IV q6h
  • 6. Pseudomonas aeruginosa
  • 7. Anaerobes
  • Alternative regimen (2): Ceftriaxone 2 g IV q24h (against gram-positive anaerobes)
  • Alternative regimen (3): Metronidazole 500 mg PO tid (against gram-negative anaerobes)

Osteomyelitis, sternal

  • Osteomyelitis, sternal [14]
  • Preferred regimen: Vancomycin 1 g IV q12h (If over 100kg, 1.5 g IV q12h)
  • Alternative regimen: Linezolid 600 mg po/IVNAI bid

Osteonecrosis of the jaw

  • 1. Bacterial Infection [15]
  • Preferred regimen (1): Penicillin VK 500 mg PO q6–8h for 7–10 days (maintenance: 500 mg PO bid)
  • Preferred regimen (2): Amoxicillin 500 mg PO q8h for 7–10 days (maintenance: 500 mg PO bid)
  • Alternative regimen (1): Clindamycin 150–300 mg PO qid
  • Alternative regimen (4): Azithromycin 500 mg PO single dose THEN 250 mg PO qd for 4 days
  • 2. Fungal Infection
  • Preferred regimen (1): Nystatin oral suspension 5–15 mL swish qid
  • Preferred regimen (2): Fluconazole 200 mg PO qd THEN 100 mg q24h
  • Preferred regimen (3): Clotrimazole 10 mg PO tid for 7–10 days
  • 3. Viral Infection
  • Preferred regimen (1): Acyclovir 400 mg PO bid

Reactive arthritis, post-streptococcal arthritis

  • Reactive arthritis, post-streptococcal arthritis [16]
  • Treat strep pharyngitis and then NSAIDs (Prednisone needed in some patients)

Reactive arthritis, Reiter's syndrome

  • Reactive arthritis, Reiter's syndrome [17]
  • Only treatment is non-steroidal anti-inflammatory drugs

Septic arthritis, Brucella melitensis

  • Septic arthritis, Brucella melitensis [18]

Septic arthritis, candidal

  • Septic arthritis, candidal [2]
  • Preferred regimen (1): Fluconazole 400 mg/day (6 mg/kg/day) for at least 6 weeks
  • Alternative regimen (2): Caspofungin 70-mg loading dose THEN 50 mg/day
  • Alternative regimen (4): Amphotericin B deoxycholate 0.5–1 mg/kg/day for several weeks THEN Fluconazole to completion
  • Note: Duration of therapy usually is for at least 6 weeks, but few data are available; Surgical debridement is recommended for all cases; For infected prosthetic joints, removal is recommended for most cases.

Septic arthritis, gonococcal

  • Septic arthritis, gonococcal [19]
  • Preferred regimen: Ceftriaxone 1 g intramuscularly IM/IV q24h
  • Alternative regimen (1): Cefotaxime 1 g IV q8h
  • Alternative regimen (3): Spectinomycin 2 g IV q12h (Penicillin allergies)
  • Alternative regimen (4): Ciprofloxacin 500 mg IV q12h OR Ofloxacin 400 mg IV q12h (β-lactam-allergic patient)
  • Note: The tetracyclines (except in pregnant women) or penicillins may be used if the infecting organism is proven to be susceptible
  • Pediatric regimen:
  • >45 kg
  • Preferred regimen: Ceftriaxone 50 mg/kg (Maximum, 2 g/dose) IM/IV single dose for 10 to 14 days
  • <45 kg
  • Preferred regimen: Ceftriaxone 50 mg/kg (Maximum, 1 g/dose) IM/IV single dose for 7 days

Septic arthritis, Gram-negative bacilli

  • Septic arthritis, Gram-negative bacilli [20]
  • Preferred regimen (2): Cefepime 2 g IV q8–12h
  • Alternative regimen (2): Imipenem 500 mg IV q6h
  • Alternative regimen (3): Meropenem 1 g IV q8h
  • Alternative regimen (4): Doripenem 500 mg IV q8h

Septic arthritis, Histoplasmosis

  • Septic arthritis, histoplasmosis[21]
  • 1. Mild disease
  • 2. Severe disease
  • Preferred regimen: Prednisone 0.5–1.0 mg/kg/day (Maximum, 80 mg/day) in tapering doses over 1–2 weeks AND Itraconazole 200 mg tid for 3 days, followed by qd or bid for 6–12 weeks

Septic arthritis, Lyme disease

  • Septic arthritis, Lyme disease [22]
  • 1. Patients without clinical evidence of neurologic disease
  • Preferred regimen (1): Doxycycline 100 mg bid for 28 days
  • Preferred regimen (2): Amoxicillin 500 mg tid for 28 days
  • Pediatric regimen (3): (if the patient is ≥8 years of age) Doxycycline 4 mg/kg/day bid (Maximum, 100 mg/dose)
  • 2. Patients with arthritis and objective evidence of neurologic disease
  • Note (1): For patients who have persistent or recurrent joint swelling after a recommended course of oral antibiotic therapy, we recommend re-treatment with another 4-week course of oral antibiotics or with a 2–4-week course of Ceftriaxone IV
  • Note (2): If patients have no resolution of arthritis despite intravenous therapy and if PCR results for a sample of synovial fluid (and synovial tissue if available) are negative, symptomatic treatment is recommended, which consist of nonsteroidal anti-inflammatory agents, intra-articular injections of corticosteroids, or disease-modifying antirheumatic drugs (DMARDs), such as Hydroxychloroquine.

Septic arthritis, Mycobacterium tuberculosis

  • Septic arthritis, Mycobacterium tuberculosis[23]
  • 1. Septic arthritis caused by susceptible Mycobacterium tuberculosis
  • 1.1 Adults
  • 1.1.1 Intensive phase
  • Preferred regimen: Isoniazid 5 mg/kg (max, 300 mg) for 2 months AND Rifampin 10 mg/kg (max: 600 mg) for 2 months AND Pyrazinamide 15–30 mg/kg (max: 2 g) for 2 months AND Ethambutol 15–20 mg/kg (max: 1 g) for 2 months
  • 1.1.2 Continuation phase
  • Preferred regimen: Isoniazid 5 mg/kg (max: 300 mg) for 7 months AND Rifampin 10 mg/kg (max: 600 mg) for 7 months
  • 1.2 Pediatric
  • 1.2.1 Intensive phase
  • Preferred regimen: Isoniazid 10–15 mg/kg (max: 300 mg) for 2 months AND Rifampin 10–20 mg/kg (max: 600 mg) for 2 months AND Pyrazinamide 15–30 mg/kg (max: 2 g) for 2 months AND Ethambutol 15–20 mg/kg (max: 1 g) for 2 months
  • 1.2.2 Continuation phase
  • Preferred regimen: Isoniazid 10–15 mg/kg (max: 300 mg) for 7 months AND Rifampin 10–20 mg/kg (max: 600 mg) for 7 months
  • 2. Specific considerations
  • 2.1 Pregnancy and breastfeeding
  • With the exception of streptomycin, the first line anti-TB drugs are safe for use in pregnancy: Streptomycin is ototoxic to the fetus and should not be used during pregnancy.
  • After active TB in the baby is ruled out, the baby should be given 6 months of isoniazid preventive therapy, followed by BCG vaccination.
  • Pyridoxine supplementation is recommended for all pregnant or breastfeeding women taking isoniazid.
  • 2.2 Liver disorders
  • Two hepatotoxic drugs (rather than the three in the standard regimen):
  • One hepatotoxic drug:
  • No hepatotoxic drugs:
  • 2.3 Renal failure and severe renal insufficiency
  • The recommended initial TB treatment regimen for patients with renal failure or severe renal insufficiency is 2 months of isoniazid, rifampicin, pyrazinamide and ethambutol, followed by 4 months of isoniazid and rifampicin.
  • There is significant renal excretion of ethambutol and metabolites of pyrazinamide, and doses should therefore be adjusted.
  • Three times per week administration of these two drugs at the following doses is recommended: pyrazinamide (25 mg/kg), and ethambutol (15 mg/kg)
  • While receiving isoniazid, patients with severe renal insufficiency or failure should also be given pyridoxine in order to prevent peripheral neuropathy.
  • Because of an increased risk of nephrotoxicity and ototoxicity, Streptomycin should be avoided in patients with renal failure. If Streptomycin must be used, the dosage is 15 mg/kg, two or three times per week, to a maximum of 1 gram per dose, and serum levels of the drug should be monitored.
  • 2.4 Previously treated patients in settings with rapid DST
  • TB patients whose treatment has failed or other patient groups with high likelihood of multidrug-resistant TB (MDR) should be started on an empirical MDR regimen.
  • TB patients returning after defaulting or relapsing from their first treatment course may receive the retreatment regimen containing first-line drugs 2HRZES/1HRZE/5HRE if country-specific data show low or medium levels of MDR in these patients or if such data are not available.
  • 2.5 TB treatment in people living with HIV
  • TB patients with known positive HIV status and all TB patients living in HIV prevalent settings should receive daily TB treatment at least during the intensive phase.
  • For the continuation phase, the optimal dosing frequency is also daily for these patients.
  • If a daily continuation phase is not possible for these patients, three times weekly dosing during the continuation phase is an acceptable alternative.
  • It is recommended that TB patients who are living with HIV should receive at least the same duration of TB treatment as HIV-negative TB patients.

Septic arthritis, pneumococcal

Septic arthritis, post-intraarticular injection

  • Septic arthritis, post-intraarticular injection [24]
  • NO empiric therapy.

Septic arthritis, prosthetic joint infection

  • Septic arthritis, prosthetic joint infection (device-related osteoarticular infections) [25]
  • 1. Empiric antimicrobial therapy
  • It is preferable to delay antibiotic therapy until specimens for culture are obtained by joint aspiration, joint debridement, and/or prosthesis removal.
  • 2. Pathogen-directed antimicrobial therapy
  • 2.1 Staphylococcus aureus, methicillin-susceptible (MSSA)
  • Preferred regimen (1): Nafcillin 2 g IV q4–6h
  • Preferred regimen (2): Oxacillin 2 g IV q4–6h
  • Alternative regimen (1): Cefazolin 1–2 g IV q8h
  • Alternative regimen (2): Ceftriaxone 2 g IV q24h
  • Alternative regimen (3): (if allergic to penicillins) Clindamycin 900 mg IV q8h
  • Alternative regimen (4): (if allergic to penicillins) Vancomycin 15–20 mg/kg IV q8–12h (Maximum, 2 g/dose)
  • 2.2 Staphylococcus, methicillin-resistant (MRSA)
  • 2.2.1 Early-onset or acute hematogenous prosthetic joint infections involving a stable implant with short duration (< 3 weeks) of symptoms and debridement (but device retention)
  • Preferred regimen: Vancomycin AND Rifampin 600 mg PO qd or 300–450 mg PO bid for 2 weeks
  • Alternative regimen: (Daptomycin 6 mg/kg IV q24h OR Linezolid 600 IV q8h) AND Rifampin 600 mg PO qd or 300–450 mg PO bid for 2 weeks
  • Note: The above regimen should be followed by Rifampin plus a fluoroquinolone, TMP/SMX, a tetracycline or Clindamycin for 3 or 6 months for hips and knees, respectively.
  • 2.2.2 Early-onset spinal implant infections or implants in an actively infected site
  • Initial parenteral therapy plus Rifampin followed by prolonged oral therapy is recommended.
  • Long-term oral suppressive antibiotics (eg, TMP-SMX, a tetracycline, a fluoroquinolone [which should be given in conjunction with Rifampin due to the potential emergence of fluoroquinolone resistance)
  • 2.3 Streptococci, beta-hemolytic
  • Preferred regimen (1): Penicillin 12–18 MU/day IV q6h
  • Preferred regimen (3): Ceftriaxone 1–2 g IV q24h
  • Alternative regimen (1): (if allergic to penicillins) Clindamycin 900 mg IV q8h
  • Alternative regimen (2): (if allergic to penicillins) Vancomycin 15–20 mg/kg IV q8–12h (Maximum, 2 g/dose)
  • 2.4 Enterococci
  • 2.4.1 Monotherapy
  • Preferred regimen (1): Ampicillin 6-12 g/day q4-6h
  • Preferred regimen (2): Penicillin G 18-30 MU/day continuously or q4h
  • Preferred regimen (3): Vancomycin 15-20 mg/kg/dose q8-12h (Maximum, 2 g/dose)
  • 2.4.2 Combination therapy (one of the monotherapy agents, and one of the following agents)
  • 2.5 Gram-negative bacilli
  • Patients susceptible to fluoroquinolones
  • 2.5.1 P. aeruginosa
  • Preferred regimen (1): Cefepime 2 g IV q12h
  • 2.6 Anaerobes
  • 2.6.1Propionibacterium acnes
  • Preferred regimen (1): Penicillin 24 MU/day IV q4h or continuously
  • 2.6.2 Not Propionibacterium acnes
  • Preferred regimen: Metronidazole 500 mg PO tid
  • 2.7 Mycobacterium tuberculosis
  • Preferred regimen: see (Septic arthritis, Mycobacterium tuberculosis)
  • 2.8 Fungi
  • Preferred regimen: see (Septic arthritis, candidal)
  • 2.9 Culture negative

Septic arthritis, staphylococcal

  • 1.Staphylococcus aureus (methicillin-resistant)[26][27]
  • Preferred regime: Vancomycin 15–20 mg/kg IV q8–12h
  • Alternative regimen (1): Daptomycin 6 mg/kg IV q24h
  • Alternative regimen (2): Linezolid 600 mg PO/IV q12h
  • Alternative regimen (3): Clindamycin 600 mg PO/IV q8h
  • Alternative regimen (4): TMP-SMX 3.5–4.0 mg/kg PO/IV q8–12h
  • Pediatric regimen(1): Vancomycin 15 mg/kg IV q6h
  • Pediatric regimen(1): Daptomycin 6–10 mg/kg IV q24h
  • Pediatric regimen(1): Linezolid 10 mg/kg PO/IV q8h
  • Pediatric regimen(1): Clindamycin 10–13 mg/kg/dose PO/IV q6–8h

2. Staphylococcus aureus (methicillin-susceptible)

  • Preferred regimen (2): Clindamycin 900 mg IV q8h
  • Alternative regimen (1): Cefazolin 0.25–1 g IV/IM q6–8h
  • Alternative regimen (2): Vancomycin 500 mg IV q6h or 1 g IV q12h

3. Staphylococcus epidermidis (methicillin-resistant)

  • Preferred regimen (1): Vancomycin 500 mg IV q6h or 1 g IV q12h
  • Preferred regimen (2): Linezolid 600 mg IV q12h
  • Alternative regimen: (TMP-SMX 3.5–4.0 mg/kg PO/IV q8–12h (TMP component) OR Minocycline 200 mg PO single dose THEN 100 mg PO q12h) AND Rifampin 300–600 mg PO/IV q12h

4. Staphylococcus epidermidis (methicillin-susceptible)

  • Preferred regimen (1): Nafcillin 2 g IV q6h
  • Preferred regimen (2): Clindamycin 900 mg IV q8h
  • Alternative regimen (1): Cefazolin 0.25–1 g IV/IM q6–8h
  • Alternative regimen (2): Vancomycin 500 mg IV q6h or 1 g IV q12h

Septic arthritis, streptococcal

1. Streptococcus agalactiae [28]

  • Preferred regimen (1): Penicillin G 2 MU IV/IM q4h
  • Preferred regimen (2): Ampicillin 2 g IV q6h
  • Alternative regimen (1): Clindamycin 600–1200 mg/day IV/IM q6–12h
  • Alternative regimen (2): Cefazolin 0.25–1 g IV/IM q6–8h

2. Streptococcus pyogenes

  • Preferred regimen (1): Penicillin G 2 MU IV/IM q4h
  • Preferred regimen (2): Ampicillin 2 g IV q6h
  • Alternative regimen (1): Clindamycin 600–1200 mg/day IV/IM q6–12h
  • Alternative regimen (2): Cefazolin 0.25–1 g IV/IM q6–8h

References

  1. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  2. 2.0 2.1 Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE; et al. (2009). "Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America". Clin Infect Dis. 48 (5): 503–35. doi:10.1086/596757. PMID 19191635.
  3. Spellberg B, Lipsky BA (2012). "Systemic antibiotic therapy for chronic osteomyelitis in adults". Clin Infect Dis. 54 (3): 393–407. doi:10.1093/cid/cir842. PMC 3491855. PMID 22157324.
  4. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  5. Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG; et al. (2013). "2012 infectious diseases society of america clinical practice guideline for the diagnosis and treatment of diabetic foot infections". J Am Podiatr Med Assoc. 103 (1): 2–7. PMID 23328846.
  6. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  7. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  8. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  9. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  10. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  11. Kowalski TJ, Berbari EF, Huddleston PM, Steckelberg JM, Mandrekar JN, Osmon DR (2007). "The management and outcome of spinal implant infections: contemporary retrospective cohort study". Clin Infect Dis. 44 (7): 913–20. doi:10.1086/512194. PMID 17342641.
  12. Gentry LO (1991). "Oral antimicrobial therapy for osteomyelitis". Ann Intern Med. 114 (11): 986–7. PMID 2024868.
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  18. Corbel, Michael (2006). Brucellosis in humans and animals. Geneva: World Health Organization. ISBN 9241547138.
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  22. Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS; et al. (2006). "The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America". Clin Infect Dis. 43 (9): 1089–134. doi:10.1086/508667. PMID 17029130.
  23. Treatment of Tuberculosis: Guidelines. WHO Guidelines Approved by the Guidelines Review Committee (4th ed.). Geneva: World Health Organization. 2010. ISBN 9789241547833. PMID 23741786. Retrieved 2015-06-08.
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  25. Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM; et al. (2013). "Executive summary: diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America". Clin Infect Dis. 56 (1): 1–10. doi:10.1093/cid/cis966. PMID 23230301.
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  27. Sharff KA, Richards EP, Townes JM (2013). "Clinical management of septic arthritis". Curr Rheumatol Rep. 15 (6): 332. doi:10.1007/s11926-013-0332-4. PMID 23591823.
  28. "Clinical Management of Septic Arthritis" (PDF).