Comment on: Guidelines for the management of the hot swollen joint in adults: reply
Abstract
Letters to the Editor revision of the guideline lies with the BSR Standards, Guidelines and Audit Working Group rather than us, and we are sure they will consider this and other responses to the existing guideline when planning future updates. Regarding the duration and route of administration of antibiotics in septic arthritis, the guideline does suggest 2 weeks of intravenous antibiotics and 4 weeks oral as a general rule. It also indicates circumstances under which longer courses, or changes of antibiotics, should be considered. We agree that it would be helpful to have a stronger evidence base regarding the use of antibiotics in septic arthritis. However, the logistic problems of undertaking randomized trials of a rare, rapidly progressive and life-threatening infection appear formidable. We are not optimistic that they will be forthcoming. The authors have declared no conflicts of interest. G. COAKLEY, C. MATHEWS, M. FIELD1, A. JONES2, G. KINGSLEY3, D. WALKER4, M. PHILLIPS5, C. BRADISH6, A. MCLACHLAN7, V. WESTON8 on behalf of the British Society for Rheumatology Standards, Guidelines and Audit Working Group Queen Elizabeth Hospital, Woolwich, London, 1Centre for Rheumatic Diseases, Royal Infirmary, Glasgow, 2City Hospital, Nottingham, 3University Hospital Lewisham, London, 4Freeman Hospital, Newcastle, 5Kingâs College