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

## TL;DR

This study found that 21 days of antibiotics after surgery for septic elbow bursitis reduces the risk of complications and improves recovery.

## Contribution

The study identifies 21 days as the optimal postoperative antibiotic duration for septic olecranon bursitis.

## Key findings

- Staphylococcus aureus was the most common pathogen in surgically treated septic olecranon bursitis.
- 21 days of postoperative antibiotics was associated with the lowest odds of clinical failure.
- Active smokers had significantly higher odds of clinical failure compared to nonsmokers.

## Abstract

Introduction: The absence of a standardized postoperative antibiotic treatment approach for patients with surgically treated septic bursitis results in disparate practices. Methods: We retrospectively reviewed charts of adult patients with surgically treated septic olecranon bursitis at Mayo Clinic sites between 1 January 2000 and 20 August 2022, focusing on their clinical presentation, diagnostics, management, postoperative antibiotic use, and outcomes. Results: A total of 91 surgically treated patients were identified during the study period. Staphylococcus aureus was the most common pathogen (64 %). Following surgery, 92 % (84 of 91 patients) received systemic antibiotics. Excluding initial presentations of bacteremia or osteomyelitis (
n=5
), the median duration of postoperative antibiotics was 21 d (interquartile range, IQR: 14–29). Postoperative complications were observed in 23 % (21 of 91) of patients, while cure was achieved in 87 % (79 of 91). Active smokers had 4.53 times greater odds of clinical failure compared with nonsmokers (95 % confidence interval, 95 % CI: 1.04–20.50;
p=0.026
). The highest odds of clinical failure were noted in cases without postoperative antibiotic administration (odds ratio, OR: 7.4). Conversely, each additional day of antibiotic treatment, up to 21 d, was associated with a progressive decrease in the odds of clinical failure (OR: 1 at 21 d). Conclusion: The optimal duration of antibiotics postoperatively in this study was 21 d, which was associated with a 7.4-fold reduction in the odds clinical failure compared with cases without postoperative antibiotics. Further validation through a randomized controlled trial is needed.