{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:46:26Z","timestamp":1790419586096,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002377"],"award-info":[{"award-number":["UL1TR002377"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Many guidelines for septic olecranon bursitis recommend aspiration of the bursa prior to initiation of antimicrobial therapy despite the absence of robust clinical data to support this practice and known risk of aspiration complications. Our objective was to describe outcomes associated with empiric antibiotic therapy without bursal aspiration among emergency department (ED) patients with suspected septic olecranon bursitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective observational cohort study of patients presenting to an academic ED from January 1, 2011, to December 31, 2018, with olecranon bursitis. The health record was reviewed to assess patient characteristics and outcomes within 6\u00a0months of the ED visit. Olecranon bursitis was considered \u201csuspected septic\u201d if the patient was treated with antibiotics. The primary outcome of interest was complicated versus uncomplicated bursitis resolution. Uncomplicated resolution was defined as bursitis resolution without subsequent bursal aspiration, surgery, or hospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 264 ED patients were evaluated for 266 cases of olecranon bursitis. The median age was 57\u00a0years and 85% were men. Four (1.5%) patients had bursal aspiration during their ED visit, 39 (14.7%) were admitted to the hospital, 76 (28.6%) were dismissed without antibiotic therapy, and 147 (55.3%) were dismissed with empiric antibiotic therapy for suspected septic olecranon bursitis. Among these 147 patients, 134\u00a0had follow\u2010up available including 118 (88.1%, 95% confidence interval [CI]\u00a0= 81.1%\u201392.8%) with an uncomplicated resolution, eight (6.0%, 95% CI\u00a0= 2.8%\u201311.8%) who underwent subsequent bursal aspiration, and nine (6.7%, 95% CI\u00a0= 3.3%\u201312.7%) who were subsequently admitted for inpatient antibiotics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Eighty\u2010eight percent of ED patients with suspected septic olecranon bursitis treated with empiric antibiotics without aspiration had resolution without need for subsequent bursal aspiration, hospitalization, or surgery. Our findings suggest that empiric antibiotics without bursal aspiration may be a reasonable initial approach to ED management of select patients with suspected septic olecranon bursitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14406","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T09:28:18Z","timestamp":1635240498000},"page":"6-14","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of empiric antibiotic management of septic olecranon bursitis without bursal aspiration in emergency department patients"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1304-1755","authenticated-orcid":false,"given":"Adrian","family":"Beyde","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa L.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Emergency Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina M.","family":"Colbenson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Sports Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Sandefur","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imtithal","family":"Kisirwan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan F.","family":"Mullan","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn W.","family":"O\u2019Driscoll","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronna L.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2018.10.006"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107689909201006"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2019.06.012"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-014-2088-3"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-013-1882-7"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.2000.11439458"},{"key":"e_1_2_10_8_1","first-page":"400","article-title":"Complications following resection of the olecranon bursa","volume":"72","author":"Degreef I","year":"2006","journal-title":"Acta Orthop Belg"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-017-1030-3"},{"key":"e_1_2_10_12_1","first-page":"171","article-title":"Olecranon septic bursitis managed in an ambulatory setting. The Calgary Home Parenteral Therapy Program Study Group","volume":"24","author":"Laupland KB","year":"2001","journal-title":"Clin Invest Med"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-89-1-21"},{"key":"e_1_2_10_14_1","first-page":"1160","article-title":"Septic bursitis: presentation, treatment and prognosis","volume":"14","author":"Raddatz DA","year":"1987","journal-title":"J Rheumatol"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2016.08.007"},{"key":"e_1_2_10_16_1","first-page":"663","article-title":"The clinical spectrum of severe septic bursitis in northwestern Spain: a 10 year study","volume":"26","author":"Garcia\u2010Porrua C","year":"1999","journal-title":"J Rheumatol"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14406","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.14406","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14406","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T17:29:53Z","timestamp":1693243793000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.14406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,9]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/acem.14406"],"URL":"https:\/\/doi.org\/10.1111\/acem.14406","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,9]]},"assertion":[{"value":"2021-07-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}