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What specific criteria or patient conditions would make you hesitant to use fluoroquinolones early in the treatment course for managing MSSA joint infections with oral antibiotics?

For example, baseline QT prolongation, elderly age group, or underlying heart disease?
Community PollStarted

If both are available options would you prefer an oral Quinolone or Minocycline in a joint infection being treated orally? Would it matter if it were gram positive or gram negative?

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3 Answers
Mednet Member
Mednet MemberInvited Expert
Infectious Disease · Nebraska Medical Center
Answered on

For MSSA joint infections, I have moved away from using FQ to using high-dose cephalosporins as a step-down therapy, particularly cefadroxil 1 g twice daily, given less frequent dosing/increased adherence. Considering the risk-benefit analysis, I prefer using FQ as an oral option in polymicrobial an...

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Mednet Member
Mednet Member
Infectious Disease · Crossroads Virology
Answered on

I avoid the first gen FQs mainly levo and cipro due to their low barrier to resistance in mono therapy, and only use moxi if it is doxycycline and Minocycline resistant. The tendinopathy makes it difficult to differentiate from joint pain.

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Mednet Member
Mednet Member
Infectious Disease · Beebe Infectious Disease
Answered on

Bottom line: MOXI is my favorite to use if a susceptible staph, strep, or GNR. It is much easier to tolerate than MINO and is once daily, making it easier to navigate the dietary restrictions.

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I use quite a bit of moxifloxacin for bone/joint infections, especially prosthetic join...

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