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 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...

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.

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.

-------------------

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