From the Research
For treating septic bursitis, empiric antibiotic therapy should initially target Staphylococcus aureus, the most common causative organism, with first-line treatment typically including cephalexin, dicloxacillin, or clindamycin for methicillin-sensitive strains, as supported by 1. The choice of antibiotic is crucial in managing septic bursitis, and the most recent and highest quality study 1 suggests that ceftriaxone could be a viable alternative for the treatment of methicillin-susceptible Staphylococcus aureus infections, which are commonly associated with septic bursitis. Some key points to consider in the treatment of septic bursitis include:
- The importance of early recognition and prompt initiation of appropriate antibiotic therapy, as highlighted in 2.
- The need for surgical management in some cases, particularly those that do not respond to antibiotics within 3-5 days or for complicated infections, as mentioned in 2 and 3.
- The potential benefits of percutaneous suction-irrigation as a safe and effective method of treatment, especially in severe cases where continuous drainage is desirable, as demonstrated in 3.
- The role of rest, elevation, immobilization, and serial drainage of the infected bursa as adjunctive treatments to antibiotics, as suggested in the examples provided.
- The consideration of hospitalization and intravenous antibiotic therapy for cases with fulminant local infection, evidence of systemic toxicity, or infection in immunocompromised patients, as indicated in 4. Given the variety of potential causative organisms and the severity of septic bursitis, it is essential to adjust antibiotics based on culture and sensitivity results from bursal fluid aspiration, which should be performed before starting antibiotics when possible, as emphasized in 5.