Initial therapy for Kingella kingae native bone or joint infection

The regimens below are recommended for adults and children with osteomyelitis of native bone, or septic arthritis of a native joint, when infection is caused by Kingella kingae.

For adults and children with osteomyelitis or septic arthritis caused by K. kingae, without susceptibility results or with benzylpenicillin resistance, use:

cefazolin 2 g (child: 50 mg/kg up to 2 g) intravenously, 8-hourly. For dosage adjustment in adults with kidney impairment, see cefazolin dosage adjustment. See advice on modification and duration of therapy. cefazolin cefazolin cefazolin

For adults and children with osteomyelitis or septic arthritis caused by benzylpenicillin-susceptible K. kingae use:

benzylpenicillin 1.2 g (child: 50 mg/kg up to 1.2 g) intravenously, 6-hourly. For dosage adjustment in adults with kidney impairment, see benzylpenicillin dosage adjustment. See advice on modification and duration of therapy benzylpenicillin benzylpenicillin benzylpenicillin.

For adults and children who have had a nonsevere (immediate or delayed) or a severe immediate¹ hypersensitivity reaction to a penicillin, use cefazolin as above.

For patients who have had a severe delayed² hypersensitivity reaction to a penicillin, seek expert advice.

¹ Severe immediate hypersensitivity reactions include anaphylaxis, compromised airway, airway angioedema, hypotension and collapse.Return

² Severe delayed hypersensitivity reactions include cutaneous adverse drug reactions (eg drug rash with eosinophilia and systemic symptoms [DRESS], Stevens–Johnson syndrome/toxic epidermal necrolysis [SJS/TEN], severe blistering or desquamative rash), and significant internal organ involvement (eg acute interstitial nephritis).Return