Etiology

• Hematogenous
• Contiguous
• Direct inoculation

Organisms

• Staph aureus, coag-negative staph, aerobic GNB

• Plain film
• If negative, MRI +/- contrast can detect osteo earlier than plain film
• ACR appropriateness criteria for osteo
• Gold standard is sterile bone biopsy
• If patient is hemodynamically stable, hold antibiotics until the bone biopsy can be obtained to maximize yield

• Organism specific IV abx x 6 weeks from date of last debridement
• Carbapenem or beta-lactamase inhibitor
• AND clinda (anti-toxin effects)
• AND MRSA coverage (e.g. vanc)