From the Research
Septic bursitis can be effectively managed with empiric antibiotic therapy without bursal aspiration in select patients, with a high rate of uncomplicated resolution, as demonstrated in a recent study 1.
Key Considerations
- The most common causative organism of septic bursitis is Staphylococcus aureus, and initial empiric antibiotics should target this organism.
- Options for empiric antibiotics include cephalexin, dicloxacillin, or clindamycin, with consideration of MRSA coverage in certain cases.
- Needle aspiration or surgical drainage may be necessary for olecranon or prepatellar bursitis with significant fluid collection.
- Patients should rest the affected joint, apply warm compresses, elevate the limb when possible, and take anti-inflammatory medications as needed for pain and swelling.
Management Approach
- Empiric antibiotic therapy without bursal aspiration may be a reasonable initial approach for select patients with suspected septic olecranon bursitis, as shown in a study with a high rate of uncomplicated resolution (88.1%) 1.
- Hospitalization with intravenous antibiotics may be required for severe cases, systemic symptoms, or immunocompromised patients.
- The choice of antibiotic regimen should be guided by the severity of the infection, the presence of comorbidities, and the risk of MRSA.
Supporting Evidence
- A retrospective observational cohort study of 264 ED patients with olecranon bursitis found that empiric antibiotic therapy without bursal aspiration was associated with a high rate of uncomplicated resolution 1.
- Other studies have also demonstrated the effectiveness of antibiotic therapy in the management of septic bursitis, with consideration of factors such as the presence of trauma, bursitis site, and management type 2, 3, 4, 5.