Management of bone and joint infections due to Staphylococcus aureus

The clinical presentation, investigation, treatment and prevention of osteomyelitis, septic arthritis, and prosthetic joint infections due to Staphylococcus aureus are discussed in this review. It is difficult to make evidence-based recommendations on the treatment of these infections, as very little high quality clinical evidence exists. Experimental evidence, case series and published expert opinion are reviewed and used to suggest the preferred treatment options in each type of infection. A combination of prolonged intravenous antibiotic therapy and surgery is generally required for cure of S. aureus bone and joint infections. The current standard antibiotic therapy for these infections is an intravenous beta-lactam agent. Newer antibiotic approaches, such as use of fluoroquinolones and rifampicin are reviewed, as are newer surgical approaches, such as attempted salvage of infected prosthetic joints.