Suggest Treatment For Infection In The Left Knee While On Cephalexin

Posted on Wed, 13 Sep 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 13 Sep 2017 Answered on

Fri, 6 Oct 2017 Last reviewed on

Question : My wife had a severe infection in her left knee and they did the third TKR on it in XXXXXXX this year and then 21 days in rehab all the while getting antibiotic via her Pic line. Since then she is taking her antibiotic orally, cephalexin, 500 mg,4 capsules daily. Her infection was streptococcus equine. Her infection has subsided but is still there. Can there be an injection of antibiotic directly into her knee. Is there some other medicine that would be more effective? XXXXXXX

Answered by Dr. Ivo Ditah (1 hour later)

Brief Answer:
Did she get a culture done?

Detailed Answer:
Hi and thanks so much for this query.

I have reviewed this information fully.

1. Antibiotics in this case are often guided by the culture results. Culture identify the specific germ and the antibiotics that can be used to kill the germ. Therefore, the antibiotics are always the best indicated and there is no need switching them around.

2. Administering antibiotics in the joint would not be a great idea. This is because there are no blood vessels to absorb and carry to different areas. When administered by mouth or in a picc line, we are guaranteed that after circulation, it will get there and do the job. There is no need for direct administration of these antibiotics into the joint.

I hope this clarifies your worries. I wish you well. Feel free to follow up with me if need be.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (19 hours later)

Thanks for your prompt reply and we understand. Now, additionally, is is possible to just drain the knee since it is slightly swollen? Would that accomplish anything?

Answered by Dr. Ivo Ditah (11 hours later)

Brief Answer:
If there is a purulent fluid collection!

Detailed Answer:
Hi,

If there is purulent fluid collection at the knee, draining is the single most important act. However, am not sure if there is pus in there. I will rather recommend that the doctors evaluate to confirm and take meaningful action.

Keep me updated!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (3 days later)

DR Ditah I presume you still have the background data on my wife. She would like to exercise at the gym Friday she walked on the tread mill, slowly, and lifted a few weights but she is convinced her knee is worse this morning. Which exercises would you recommend, or avoid? The tread mill, elliptical trainer, recumbent bike, or what? Also lifting a few weights should be OK, right? How about Tai Chi which requires much standing? XXXXXXX

Answered by Dr. Ivo Ditah (25 hours later)

Brief Answer:
Does the gym have a personal trainer?

Detailed Answer:
Hi,

Do you have a personal trainer at this Gym? If you do, I will suggest that you ask the personal trainer as they know what exercises are possible given the machine they have. It would be difficult to do so from a distance.

The goal is to do exercises that will mot cause her any increased pain. Also, I will prefer activities that do not require the knee at this time.

I wish your wife and you well.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar