Gonococcal septic arthritis

Septic arthritis is the most common presentation of disseminated gonococcal infection and is usually preceded by asymptomatic mucosal infection. Gonococcal arthritis may not require joint washouts. For antibiotic therapy for gonococcal septic arthritis in adults and children, use:

1ceftriaxone 2 g (child: 50 mg/kg up to 2 g) intravenously, daily ceftriaxone ceftriaxone ceftriaxone

1cefotaxime 2 g (child: 50 mg/kg up to 2 g) intravenously, 8-hourly. For dosage adjustment in adults with kidney impairment, see cefotaxime dosage adjustment. cefotaxime cefotaxime cefotaxime

For adults and children who have had a nonsevere (immediate or delayed) or a severe immediate¹ hypersensitivity reaction to a penicillin, ceftriaxone or cefotaxime (at the dosages above) can be used.

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

For adults and children with gonococcal arthritis, continue intravenous therapy until the patient has been afebrile for 48 hours, then switch to oral therapy (according to the results of culture and susceptibility testing). Total treatment duration is 7 days. See Principles of sexually transmissible infection (STI) management for advice on further testing and contact tracing.

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