Intravenous drug use

- Predilection for sternoclavicular or sacroiliac joint, ribs, vertebrae, long bones.

- Must rule out endocarditis.

 
Usual Pathogens

S. aureus/MRSA
Streptococcus spp

 

Occasionally:

P. aeruginosa

Salmonella spp
Serratia spp
Candida spp (consult ID)
Anaerobes

 
Rare:

M. tuberculosis (consult ID)

 

Empiric Therapy Dose Duration
Vancomycin 15mg/kg IV q12h 6 weeks
+    
Ceftriaxone 1-2g IV daily