Right Antibiotic, Right Discharge: Ethical Tensions Between Antimicrobial Stewardship and Social Vulnerability

In a case of a patient with postoperative septic arthritis and hardware-associated osteomyelitis due to methicillin-susceptible Staphylococcus aureus that is susceptible to multiple oral agents, the clinician must navigate not only a treatment decision between oral and intravenous antibiotics but also the ethical tension between evidence-based practice and the patient's social instability. We examined 3 interrelated ethical conflicts: balancing clinician-patient relationship with organizational priorities, weighing the benefits and harms of competing treatment decisions, and considering how patient vulnerability may shape professional duties.