From the Research
Antibiotic treatment for septic bursitis should be initiated empirically, covering Staphylococcus aureus and streptococci, with first-line options including cephalexin or dicloxacillin for 7-10 days, as supported by the most recent study 1.
Key Considerations
- The most recent study 1 suggests that empiric antibiotics without bursal aspiration may be a reasonable initial approach to ED management of select patients with suspected septic olecranon bursitis.
- Staphylococcus aureus is the most common cause of septic bursitis, as noted in studies 2 and 3.
- For patients with MRSA risk factors or penicillin allergy, alternative antibiotics such as clindamycin or trimethoprim-sulfamethoxazole may be considered, as discussed in study 4.
Treatment Approach
- Empiric antibiotic therapy should be initiated promptly, with adjustment based on culture results when available.
- Bursal drainage for purulent collections, rest, elevation, and anti-inflammatory medications should accompany antibiotic treatment.
- Non-septic bursitis (from trauma or overuse) does not require antibiotics and should be treated with rest, ice, compression, and NSAIDs.
Important Notes
- Clinical improvement should be seen within 48-72 hours; lack of response may indicate resistant organisms, deeper infection, or non-infectious etiology requiring further evaluation.
- The duration of antibiotic therapy may vary depending on the severity of the infection and the patient's response to treatment, as suggested by study 3.