Septic arthritis is not a frequent, but quite classical pathology in children. It can be followed by a severe outcome in case of delayed and/or inadequate treatment. The drainage of the infected joint associated with a prompt and adapted antibiotherapy are together the cornerstones of this treatment. The isolation and identification of the causative microorganism is also of the highest importance. Up to now, unfortunately, a large proportion of septic arthritis are treated by antibiotics although all culture remain negative. This paper has two objectives: one is to present the different steps to optimize the assessment and diagnosis; the second, to increase the sensitivity of the pathogen identification. At last, we present our proposal for empirical antibiotherapy.

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