How is nongonococcal septic arthritis treated?
• Choose effective antibiotic based on patient age, clinical situation, Gram stain, and culture results.
• Prompt and adequate drainage of the joint on a frequent basis (sometimes several times a day if using needle drainage) is essential. Always send synovial fluid for cell count, Gram stain, and culture to ensure therapy is succeeding as evidenced by decreasing cell count and cultures becoming negative. Although controversial, many clinicians feel that surgical (open, arthroscopic) drainage should be done instead of needle drainage (see Question 17).
• Physical therapy is important.