Purpose: The optimal duration of targeted systemic antibiotic therapy after lavage for native septic hand arthritis is unknown. Significant variation in daily clinical practice has been described across different centers.

Methods: We assessed variables associated with remission in septic hand and wrist arthritis by means of a retrospective cohort study of adult patients hospitalized for septic native joint arthritis of the hand and wrist between March 2007 and March 2013 at 2 university hospitals in Switzerland. The data review was principally focused on antibiotic regimens and surgical procedures.

Results: We included 80 consecutive cases of hand arthritis (median age, 56 years; 26 women and 54 men; 16 immunocompromised individuals). All patients underwent median of a 1 surgical irrigation and received concomitant systemic antibiotic therapy for a median duration of 28 days including 5 days of intravenous therapy. Remission was achieved in 74 cases (93%); however, there were 26 episodes (33%) of non-infectious sequelae such as osteoarthritis or persistent pain. No variables were associated with remission or sequelae in the multivariate logistic regression analysis. Moreover, outcomes were identical for <5 days versus ≥ 5 days of intravenous therapy and for <2 weeks versus >4 weeks of total antibiotic treatment.

Conclusions: The rate of post-surgical remission for adult native joint hand septic arthritis is high and independent of immune suppression, number of surgical debridement procedures, and modality/duration of antibiotic therapy.