From the Research
Treatment for infectious bursitis should involve antibiotics, drainage, and supportive care, with the most recent and highest quality study suggesting that adjuvant antibiotic therapy may be limited to 7 days in non-immunosuppressed patients 1. The goal of treatment is to eradicate the infection, reduce inflammation, and prevent complications.
- For mild cases, oral antibiotics such as cephalexin (500 mg four times daily), dicloxacillin (500 mg four times daily), or trimethoprim-sulfamethoxazole (one double-strength tablet twice daily) are prescribed for 7-10 days to target common pathogens like Staphylococcus aureus.
- More severe cases may require intravenous antibiotics such as cefazolin or vancomycin, especially if MRSA is suspected.
- Aspiration of the bursa is often necessary to remove purulent fluid, relieve pressure, and obtain samples for culture to guide antibiotic therapy.
- During treatment, the affected joint should be rested, elevated, and ice may be applied to reduce inflammation.
- Anti-inflammatory medications can help manage pain.
- If the infection doesn't respond to these measures or if there are complications like abscess formation, surgical intervention with incision and drainage or bursectomy may be required, as seen in a case report where a patient required surgical wash-out of the affected bursa after initial treatment with oral antibiotics 2. The choice of antibiotic therapy should be guided by the results of culture and sensitivity testing, and the duration of therapy should be individualized based on the severity of the infection and the patient's response to treatment, with some studies suggesting that shorter courses of antibiotic therapy may be effective in certain cases 1.