For acute hematogenous osteomyelitis, initial antibiotic treatment should include a penicillinase-resistant semisynthetic penicillin (eg, nafcillin or oxacillin 2 g IV every 4 hours) or vancomycin 1 g IV every 12 hours (when MRSA is prevalent in a community, which is common) and a 3rd - or 4th-generation cephalosporin (such as ceftazidime 2 g IV every 8 hours or cefepime 2 g IV every 12 hours).