Management of Orthopedic Infections

Catherine M. Oliphant, PharmD


Journal for Nurse Practitioners. 2015;11(10):1036-1042. 

In This Article

Abstract and Introduction


Orthopedic infections, such as septic arthritis, prosthetic joint infections, and osteomyelitis, are often challenging to diagnose and manage. These infections are becoming more common because of an aging population, an increase in prosthetic joints, and prevalence of diabetes. Initially, clinical findings lead to the suspicion of infection. Diagnosis is confirmed based on laboratory, microbiology, and radiographic imaging findings. Management often includes a combination of surgery and prolonged antimicrobial therapy.


Orthopedic infections can be devastating to the patient and are associated with significant costs. These infections are both challenging to diagnose as well as manage. To further complicate management, bacterial pathogens are becoming increasingly resistant to currently available antibiotics. Awareness of changing susceptibilities, even in common pathogens, will enable the practitioner to choose appropriate antimicrobial therapy. Early diagnosis relies on laboratory, radiologic, and microbiology findings. Consultation with both orthopedic surgeons and infectious disease specialists is suggested for optimal management of these difficult infections. Surgical intervention is often necessary to obtain necessary cultures, debride the infected area(s), and remove prosthetic devices, if appropriate. Antimicrobial therapy should be initiated after cultures are obtained, and prolonged courses of antibiotic therapy are often warranted. This article provides an overview of diagnosis and management of septic arthritis, prosthetic joint infections, and osteomyelitis.