Rheumatology Medical News about Cloxacillin, Severe septic bursitis, Antibiotics

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Cloxacillin-based therapy in severe septic bursitis: Retrospective study of 82 cases
Joint, Bone, Spine, 07/27/09

Martinez-Taboada VM et al. – In patients with severe septic bursitis (SB) without extensive cellulites, intravenous (i.v.) cloxacillin ( C ) alone may be sufficient. In patients with a more severe presentation, C plus gentamicin (G) seems to be an appropriate option in the majority of them.

Methods

A retrospective study to describe a tertiary care center experience with different antibiotic strategies that include C in pts with severe SB
Severe SB defined as when patient needed hospitalization and/or i.v. antibiotics
Pts were treated with bursal aspiration and one of these antibiotic options-
- C: 2 g/4 h per day i.v. until improvement, and afterwards 1 g/6 h per day v.o. until resolution
- (C + G): gentamicin i.v. was added to C for 5 to 7 days (initial dose 240 mg/d)
- (C + R): rifampicin was added at a dose of 600 mg/d v.o.

Results

82 pts with severe SB; mean delay to diagnosis was 6.1 ± 6.9 days; most frequent location was prepatellar bursa
In 67%, the bursal fluid culture yield a positive result, being Staphylococcus aureus the most frequent bacteria isolated (94.4%)
At admission, fever and extensive cellulites were more frequent in C + G group
Pts in the C + G had a longer duration of i.v. antibiotics vs C group, although the total duration of antibiotics was not different
There was a tendency in the C + R group to need more surgery
All pts except 1 had a complete resolution; no differences in side effects

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