Native bone and joint infection caused by Salmonella species

In adults and children with native bone and joint infection caused by Salmonella species, depending on susceptibility results, useWen, 2017:

1ceftriaxone 2 g (child 1 month or older: 100 mg/kg up to 2 g) intravenously, daily. See below for intravenous to oral switch ceftriaxone ceftriaxone ceftriaxone

OR

1cefotaxime 2 g (child: 50 mg/kg up to 2 g) intravenously, 6-hourly. For dosage adjustment in adults with kidney impairment, see cefotaxime dosage adjustment. See below for intravenous to oral switch cefotaxime cefotaxime cefotaxime

OR

1ciprofloxacin 400 mg (child: 10 mg/kg up to 400 mg) intravenously, 12-hourly1. For dosage adjustment in adults with kidney impairment, see ciprofloxacin intravenous dosage adjustment. See below for intravenous to oral switch. ciprofloxacin ciprofloxacin ciprofloxacin

For adults and children who have had a nonsevere (immediate or delayed) or a severe immediate2 hypersensitivity reaction to a penicillin, depending on susceptibility results, ceftriaxone, cefotaxime or ciprofloxacin (at the dosages above) can be used.

For adults and children who have had a severe delayed3 hypersensitivity reaction to a penicillin, ciprofloxacin (at the dosage above) can be used if the infection is caused by a susceptible Salmonella species. If the Salmonella species is not susceptible to ciprofloxacin, seek expert advice.

When it is appropriate to switch to oral therapy for native bone and joint infection caused by susceptible Salmonella species, useWen, 2017:

1amoxicillin 1 g (child: 30 mg/kg up to 1 g) orally, 8-hourly. For dosage adjustment in adults with kidney impairment, see amoxicillin dosage adjustment amoxicillin amoxicillin amoxicillin

OR

1ciprofloxacin 750 mg (child: 20 mg/kg up to 750 mg) orally, 12-hourly14. For dosage adjustment in adults with kidney impairment, see ciprofloxacin oral dosage adjustment. ciprofloxacin ciprofloxacin ciprofloxacin

For adults and children who have had a hypersensitivity reaction to a penicillin, ciprofloxacin (at the dosage above) can be used if the infection is caused by a susceptible Salmonella species. If the Salmonella species is not susceptible to ciprofloxacin, seek expert advice.

1 Ciprofloxacin is not licensed for use in children on the basis of animal studies that showed an adverse effect on cartilage development with quinolone use; however, clinical trial data suggest that adverse musculoskeletal events are usually mild and short term, similar to those observed in adults. Ciprofloxacin can be used in children when it is the drug of choice.Return
2 Severe immediate hypersensitivity reactions include anaphylaxis, compromised airway, airway angioedema, hypotension and collapse.Return
3 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
4 An oral liquid formulation of ciprofloxacin is not commercially available; for formulation options for children or people with swallowing difficulties, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSplus.Return