From the FDA Drug Label
In cases of β-hemolytic streptococcal infections, treatment should continue for at least 10 days. There is no information about olecranon bursitis in the provided drug labels. The FDA drug label does not answer the question.
From the Research
For olecranon bursitis requiring antibiotics, the recommended approach is to start empiric antibiotic therapy without bursal aspiration, as this has been shown to be effective in resolving the infection in a significant proportion of patients. This approach is supported by a recent study 1 that found 88% of patients with suspected septic olecranon bursitis treated with empiric antibiotics without aspiration had resolution without need for subsequent bursal aspiration, hospitalization, or surgery. Another study 2 also found that empirical management without aspiration was effective in treating uncomplicated septic olecranon bursitis, with no patients requiring bursectomy.
- The first-line antibiotic treatment can include cephalexin 500 mg orally four times daily for 7-10 days, with alternative options being dicloxacillin 500 mg orally four times daily, or clindamycin 300-450 mg orally four times daily for patients with penicillin allergies.
- Antibiotics are only indicated when infection is suspected, characterized by warmth, erythema, tenderness, and systemic symptoms like fever.
- While treating, the elbow should be rested, elevated, and compression applied to reduce swelling and promote healing.
- NSAIDs can help manage pain and inflammation, and should be used as needed.
- If there's no improvement within 48-72 hours, reassessment is needed, potentially requiring hospitalization for IV antibiotics or surgical drainage.
- It's worth noting that the traditional approach of bursal aspiration before starting antibiotics may not be necessary, as the recent studies 1, 2 suggest that empiric antibiotic therapy can be effective in resolving the infection.
- The choice of antibiotic should be guided by the suspected causative organisms, which are typically Staphylococcus aureus and streptococci, and the patient's allergy history.