Routine drug treatment of septic arthritis.

Drug treatment of septic arthritis must be initiated promptly and rationally. An accurate diagnosis of the infecting micro-organism must be made as quickly as possible. Antibiotic treatment should be started even before this is achieved using clues from the clinical evaluation and from the stained smear of synovial fluid as guides. Later, the choice and dose of the drug can be adjusted based upon the results of the culture and the bacterial sensitivity to the drug. Anti-inflammatory drugs make a real contribution to control of the postinfectious synovitis that frequently occurs, but they should not be used until control of the infection has become evident. Early diagnosis and treatment make it possible to restore joint function to normal in the majority of patients.