Antibiotic therapy of septic bursitis

Abstract

Infected olecranon, prepatellar, and infrapatellar bursae offer a unique opportunity to study the response of a closed-space infection to antibiotic therapy. Using percutaneous needle aspirations, serial bursal fluids were cultured. The length of time necessary to achieve culture sterility with antibiotic therapy (an average of 4 days in 25 patients) was correlated with the duration of symptoms prior to diagnosis (r = 0.68, P less than 0.001). In patients treated within 2 weeks from onset of symptoms, bursal fluid sterility was achieved within 1 week of therapy, while longer duration of symptoms was associated with delayed response. When antibiotic therapy was continued for 5 additional days after documented culture sterility, all 19 patients in the prospective trial were cured (average followup period of 6.8 months). In septic bursitis, the effects of delay in treatment are deleterious by prolonging culture-positivity despite adequate antibiotic therapy. By analogy, delay in treatment of septic arthritis may result in the persistence of an adverse environment which can lead to further articular damage. After accurate diagnosis of septic bursitis, a therapeutic approach consisting of prompt and appropriate antibiotic usage, frequent needle drainage, and treatment duration based on the culture results of serial aspirations is effective and may be applicable in the management of certain nongonococcal bacterial joint infections.

A systematic review of the management of acute pyogenic flexor tenosynovitis

“…The pathogenesis and resultant morbidity of PFT is similar to other closed space infections, such as septic arthritis, septic nephritis, and bacterial meningitis. (HO and Su, 1981, Sakiniene wt al., 1996; Spear et al, 2004; Wysenbeek et al, 1998) Antibiotics have improved treatment of all of these conditions. With such advances in the treatment of other challenging bacterial infections, PFT treatment with antibiotics warrants more thorough investigation.…”

“…However, cases that present early, do not yet show a rise in WBC count, and do not have any systemic symptoms may warrant a different treatment approach from the fulminant cases. Modern antibiotics have successfully treated other infectious conditions, such as infectious nephritis and periprosthetic infections, (Ho and Su, 1981; Sakiniene, 1996; Spear, 2004) and have a role in treating PFT as well. The aim of this systematic review is to evaluate the role of antibiotics in treating PFT.…”

Prepatellar Bursitis Secondary to Sepsis in the Neonatal Period

“…Since our patient was a neonatal, and sepsis co-existed together with meningitis and septic bursitis, the patient was hospitalized and vancomycin treatment was applied for S. aureus that grew in the blood culture. It is recommended that in recurrent aspirations, the treatment period be continued till the fifth day after the bursal aspirates were sterile (14). In patients who do not respond to antibiotherapy and percutaneous bursa aspirations, surgical drainage and bursectomy are recommended (1).…”

Optimal antibiotics duration following surgical management of septic olecranon bursitis: a 12-year retrospective analysis

“…Estimates suggest that both septic olecranon and prepatellar bursitis account for 0.01 % to 0.1 % of all hospital admissions (Mcafee and Smith, 1988), with half of these patients necessitating surgical intervention (Sayegh and Strauch, 2014). While surgical indications are clearly outlined in certain situations, there is still a notable void in the existing literature when it comes to postopera-tive care, particularly concerning the administration of antibiotics, which varies considerably among different healthcare institutions (Baumbach et al, 2013a(Baumbach et al, , b, 2014Ho and Su, 1981;Perez et al, 2010;García-Porrúa et al, 1999).…”