From the Guidelines
Bursitis infection treatment should prioritize incision and drainage, as well as antibiotics effective against Gram-positive bacteria, including MRSA, to reduce morbidity and mortality. The management of bursitis infection is crucial to prevent complications and improve quality of life. According to the 2018 WSES/SIS-E consensus conference recommendations 1, empiric therapy for community-acquired MRSA (CA-MRSA) should be considered for patients at risk for CA-MRSA or who do not respond to first-line therapy.
Key considerations for bursitis infection treatment include:
- Incision and drainage as the primary treatment for simple abscesses or boils, with antibiotics not needed for simple cases 1
- Antibiotic therapy against Gram-positive bacteria, including streptococci and S. aureus, for superficial infections such as impetigo, erysipelas, and cellulitis 1
- Empiric therapy for CA-MRSA for patients at risk or who do not respond to first-line therapy 1
- Use of oral beta-lactams, macrolides, or lincosamides for mild cases, and parenteral route for more severe infections 1
In terms of specific antibiotic regimens, options may include cephalexin, dicloxacillin, or clindamycin for 7-10 days, with intravenous antibiotics reserved for severe cases. Supportive care, such as rest, ice, elevation, and over-the-counter pain relievers like ibuprofen or naproxen, can also help manage symptoms and improve quality of life. Prompt treatment is essential to prevent the infection from spreading and reducing the risk of complications.
From the Research
Bursitis Infection Treatment
- Bursitis is typically caused by bacterial infections, with Staphylococcus aureus being a common culprit 2.
- Treatment of bursitis infections often involves the use of antibiotics, with the choice of antibiotic depending on the severity of the infection and the susceptibility of the bacteria to different antibiotics.
Antibiotic Options
- For methicillin-susceptible S. aureus (MSSA) infections, penicillinase-resistant penicillins (flucloxacillin, dicloxacillin) are the antibiotics of choice, while first generation cephalosporins (cefazolin, cephalothin and cephalexin), clindamycin, lincomycin and erythromycin may be used for less serious infections or in patients with penicillin hypersensitivity 2.
- Cefazolin has been shown to be effective in treating S. aureus bacteraemia, with some studies suggesting it may be associated with lower mortality rates and less nephrotoxicity compared to anti-staphylococcal penicillins (ASPs) 3.
- For patients with a beta-lactam allergy, cefazolin may still be a viable option for surgical site infection prevention after total joint arthroplasty, with one study finding it to be associated with decreased postoperative surgical site infections without an increase in interoperative hypersensitivity reactions 4.
Considerations
- The choice of antibiotic should take into account the severity of the infection, the susceptibility of the bacteria, and the patient's medical history, including any allergies or hypersensitivities.
- In cases where the bacteria are resistant to multiple antibiotics, combination therapy or the use of newer antibiotics such as linezolid or quinupristin/dalfopristin may be necessary 2.