Staphylococcal septic arthritis: antibiotic and nonsteroidal anti-inflammatory drug treatment in a rabbit model

J Orthop Res. 1997 Nov;15(6):919-26. doi: 10.1002/jor.1100150619.


This study evaluated the effects of combining antibiotic therapy with the application of a nonsteroidal anti-inflammatory drug on the degradation of articular cartilage for an animal model of Staphylococcal septic arthritis. Rabbits were infected intra-articularly with Staphylococcus aureus. Antibiotic treatment started 18 hours after infection and continued for 7 days. Treatment with the nonsteroidal anti-inflammatory drug naproxen sodium started 24 hours before infection and continued for either 3 or 7 weeks. The cartilage matrix of uninfected and infected knees was quantified by analysis of glycosaminoglycan and collagen content. Three weeks after infection, the combined treatment of the nonsteroidal anti-inflammatory drug and antibiotics reduced the loss of glycosaminoglycan and collagen from the cartilage of the infected knee by 15 and 30%, respectively, compared with antibiotic treatment alone. Continuing treatment with naproxen sodium for 7 weeks reduced the loss of collagen by 50% when compared with antibiotic treatment alone. The longer period of treatment with naproxen sodium showed little further effect on the loss of glycosaminoglycan than that observed for the 3-week treatment. Treatment with this drug and antibiotics reduced swelling of the knee and levels of prostaglandin E2 in the synovial fluid. The data support the hypothesis that decreasing post-infectious inflammation by adding the drug to a standard antibiotic regimen reduces cartilage damage from Staphylococcal septic arthritis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / blood
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Arthritis, Infectious / drug therapy*
  • Arthritis, Infectious / microbiology
  • Cartilage, Articular / metabolism
  • Ceftriaxone / therapeutic use*
  • Cephalosporins / therapeutic use*
  • Dinoprostone / metabolism
  • Disease Models, Animal
  • Drug Therapy, Combination
  • Female
  • Glycosaminoglycans / metabolism
  • Hydroxyproline / metabolism
  • Knee Joint*
  • Naproxen / blood
  • Naproxen / therapeutic use*
  • Rabbits
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus
  • Synovial Fluid / drug effects
  • Synovial Fluid / metabolism
  • Synovitis / drug therapy


  • Anti-Inflammatory Agents, Non-Steroidal
  • Cephalosporins
  • Glycosaminoglycans
  • Naproxen
  • Ceftriaxone
  • Dinoprostone
  • Hydroxyproline