General principles

Empirical antibiotic choice for post-traumatic wound infection associated with systemic features or deeper tissues (such as bones, joints or tendons) depends on the patient's risk of MRSA infection (see Risk factors for infection with methicillin-resistant Staphylococcus aureus). It is further affected by the type of injury (eg whether the wound is heavily contaminated). Modify therapy based on the results of culture and susceptibility testing.

Switch to oral therapy (see here) as soon as possible (eg 48 hours after surgery); if P. aeruginosa infection is confirmed, seek expert advice for oral continuation therapy.

Total duration of treatment (intravenous + oral) is 5 to 7 days, depending on clinical response; however, a longer duration of therapy is needed for wounds involving the deeper tissues (such as bones, joints or tendons). For the suggested duration of intravenous and oral therapy, see How to choose the duration of therapy for osteomyelitis in adults and children for infection involving bone, and Suggested duration of antibiotic therapy for native joint septic arthritis for infection involving a joint.