From the Research
For bursitis, the recommended antibiotics are typically cephalexin (500 mg four times daily), dicloxacillin (500 mg four times daily), or clindamycin (300-450 mg four times daily) for 7-10 days if the condition is infected (septic bursitis). Treatment should begin after fluid aspiration for culture to confirm infection. Not all bursitis requires antibiotics - only cases with infection, which typically present with redness, warmth, fever, and purulent drainage. For MRSA concerns, consider trimethoprim-sulfamethoxazole (1-2 DS tablets twice daily) 1. Alongside antibiotics, treatment should include rest, ice, compression, elevation, and anti-inflammatory medications like ibuprofen (400-800 mg three times daily). Severe or unresponsive cases may require surgical drainage or intravenous antibiotics. Antibiotics target the common causative organisms (usually Staphylococcus aureus or Streptococcus species) that enter through breaks in the skin or spread from nearby infections.
Key Considerations
- The most common causative organism of bursitis is Staphylococcus aureus, which is often resistant to penicillin 1.
- MRSA infections require special consideration, with vancomycin or teicoplanin being the most common treatments for severe cases 2.
- Ceftriaxone has been shown to be effective in treating MSSA bacteremia, and may be a viable alternative for the treatment of MSSA bursitis 3.
- The choice of antibiotic should be guided by culture and susceptibility results, as well as local resistance patterns.
Treatment Approach
- Begin with fluid aspiration for culture to confirm infection.
- Choose an antibiotic based on the suspected causative organism and local resistance patterns.
- Consider MRSA concerns and adjust treatment accordingly.
- Use rest, ice, compression, elevation, and anti-inflammatory medications alongside antibiotics.
- Severe or unresponsive cases may require surgical drainage or intravenous antibiotics.