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Infectious olecranon and patellar bursitis: short-course adjuvant antibiotic therapy is not a risk factor for recurrence in adult hospitalized patients

Perez, Cédric ; Huttner, Angela ; Assal, Mathieu ; Bernard, Louis ; Lew, Daniel ; Hoffmeyer, Pierre ; Uçkay, Ilker

In: Journal of Antimicrobial Chemotherapy, 2010, vol. 65, no. 5, p. 1008-1014

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    Titre
    • Infectious olecranon and patellar bursitis: short-course adjuvant antibiotic therapy is not a risk factor for recurrence in adult hospitalized patients
    Auteur
    • Perez, Cédric. Orthopaedic Surgery Service, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
    • Huttner, Angela. Service of Infectious Diseases, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
    • Assal, Mathieu. Orthopaedic Surgery Service, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
    • Bernard, Louis. Orthopaedic Surgery Service, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
    • Lew, Daniel. Service of Infectious Diseases, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
    • Hoffmeyer, Pierre. Orthopaedic Surgery Service, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
    • Uçkay, Ilker. Orthopaedic Surgery Service, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Journal of Antimicrobial Chemotherapy, 2010, vol. 65, no. 5, p. 1008-1014. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:300081
    Summary
    Objectives No evidence-based recommendations exist for the management of infectious bursitis. We examined epidemiology and risk factors for recurrence of septic bursitis. Specifically, we compared outcome in patients receiving bursectomy plus short-course adjuvant antibiotic therapy (≤7 days) with that of patients receiving bursectomy plus longer-course antibiotic therapy (>7 days). Patients and methods Retrospective study of adult patients with infectious olecranon and patellar bursitis requiring hospitalization at Geneva University Hospital from January 1996 to March 2009. Results We identified 343 episodes of infectious bursitis (237 olecranon and 106 patellar). Staphylococcus aureus predominated among the 256 cases with an identifiable pathogen (85%). Three hundred and twelve cases (91%) were treated surgically; 142 (41%) with one-stage bursectomy and closure and 146 with two-stage bursectomy. All received antibiotics for a median duration of 13 days with a median intravenous component of 3 days. Cure was achieved in 293 (85%) episodes. Total duration of antibiotic therapy [odds ratio (OR) 0.9; 95% confidence interval (95% CI) 0.8-1.1] showed no association with cure. In multivariate analysis, only immunosuppression was linked to recurrence (OR 5.6; 95% CI 1.9-18.4). Compared with ≤7 days, 8-14 days of antibiotic treatment (OR 0.6; 95% CI 0.1-2.9) or >14 days of antibiotic treatment (OR 0.9; 95% CI 0.1-10.7) was equivalent, as was the intravenous component (OR 1.1; 95% CI 1.0-1.3). Conclusions In severe infectious bursitis requiring hospitalization, adjuvant antibiotic therapy might be limited to 7 days in non-immunosuppressed patients