Bursitis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Medical therapy for traumatic bursitis includes the RICE regimen (rest, ice, compression, elevation), anti-inflammatory agents such as Aspirin, Naproxen, or Ibuprofen, ultrasound therapy, and/or corticosteroid injections. Restriction of activity is encouraged to prevent further injury and promote healing. Antimicrobial therapy is administered for infectious bursitis.

Medical Therapy

Prepatellar Bursitis

Septic prepatellar bursitis requires oral antibiotics with or without surgical excision of the bursal sac (bursectomy) depending on the patient's response and the organism involved. For instance, Staphylococcus aureus bursitis often resolves with antibiotics alone, while Sporotrix schenckii bursitis often requires bursectomy.
Most patients respond to oral antibiotics alone although some require intravenous therapy.
Aseptic prepatellar bursitis is usually managed with rest, compression, and nonsteroidal anti-inflammatory drugs (NSAIDs). Iee is not helpful except in the acute setting.
Local corticosteroid injections may be used in some patients who do not respond to initial therapy.

Olecranon Bursitis

Trochanteric Bursitis

Retrocalcaneal Bursitis

Antimicrobial Regimens

Septic bursitis ^[1]

1. Staphylococcus aureus, methicillin-susceptible (MSSA)

Preferred regimen (1): Nafcillin 2 g IV q4h
Preferred regimen (2): Oxacillin 2 g IV q4h
Preferred regimen (3): Dicloxacillin 500 mg PO qid

2. Staphylococcus aureus, methicillin-resistant (MRSA)

Preferred regimen (1): Vancomycin 1 g IV q12h
Preferred regimen (2): Linezolid 600 mg PO qd

References

↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.

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[1] Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.

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