Antibiotic prophylaxis for preventing recurrent cellulitis: A systematic review and meta-analysis

Oh, Choon Chiat; Ko, Henry; Lee, Haur Yueh; Safdar, Nasia; Maki, Dennis G.; Chlebicki, Maciej Piotr

doi:10.1016/j.jinf.2014.02.011

Cited by 52 publications

(29 citation statements)

References 30 publications

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“…[5, 9] If the consistent use of prophylactic antibiotics results in fewer hospitalizations and shorter hospital stays, then they could have a significant impact on reducing the cost of NLEC. This has been suggested in cost analyses of the UK randomized controlled trials (PATCH I and II), which demonstrated that antibiotic prophylaxis is at least 62% cost effective to both the healthcare system and society.…”

Section: Discussionmentioning

confidence: 99%

“…[7] Similarly, home administration of intravenous antibiotics via home healthcare agencies aims to reduce costs. Moreover, prophylactic antibiotics have been effective in preventing NLEC recurrence,[8, 9] which commonly occurs in patients with a first episode of NLEC; additionally, prophylaxis can be cost effective, even after the first episode of NLEC. [10] Recently introduced antibiotics, including the long half-life lipoglycopeptides (oritavancin, telavancin and dalbavancin) also provide opportunities for effective treatment with the potential to avoid hospitalization and outpatient parenteral antibiotic therapy (OPAT) costs.…”

Section: Introductionmentioning

confidence: 99%

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Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study

et al. 2017

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Background Hospital admissions for non-purulent lower extremity cellulitis (NLEC) are common and can be prolonged and costly. Newer treatment options and preventive strategies are expected to result in cost savings before implementation, but few studies have quantified the cost of conventional treatment. Methods Using the Rochester Epidemiology Project, the incidence of NLEC in Olmsted County, MN in 2013 was 176.6 per 100,000 persons. The subset of patients who required hospitalization for NLEC in 2013 was determined. Hospital admissions were analyzed retrospectively using standardized cost analysis within several relevant categories. Results Thirty-four patients had an average hospital length of stay of 4.7 days. The median total inpatient cost was $7,341. The median cost per day was $2,087, with 49% due to room and board. Antibiotics administered for treatment of NLEC contributed a median cost of $75 per day of hospitalization, and laboratory and imaging test costs were $73 and $44, respectively, per day of hospitalization. Conclusions Hospitalizations for NLEC can be costly and prolonged with room and board accounting for much of the cost. Therefore, newer management strategies should seek to reduce hospital length of stay and/or avoid inpatient admission to reduce cost.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study

et al. 2017

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“…Alt ekstremitede bir kez selülit atağı geçiren hastalarda ilk 1-3 yıl içinde nüks oranı %8-20 arasında değişmektedir (29). Amerika Birleşik Devletleri'nde yapılan bir çalışmada selülitli hastaların iki yıllık takibinde %16,7 oranında aynı ekstremitede nüks gözlenmiş ve o bölgede deri bütünlüğünü bozan dermatit varlığının bu riski artırdığı ileri sürülmüştür (30). Çalışmamızda yer alan hastalardan taburculuk sonrası ortalama 2 yıl takibi yapılabilen 34 hastanın 11'inde (%32,4) aynı ekstremitede nüks olması literatürü destekleyen bir bulgudur.…”

Section: Discussionunclassified

Retrospective Evaluation of Risk Factors and Response in Treatment among Hospitalized Patients with Lower-Extremity Cellulitis

Mehdi¹,

Ekinci²,

Baykal³

2016

tdd

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Amaç: Bacak yerleşimli selülit olgularında risk faktörlerinin ortaya çıkarılması, risk faktörlerinin tedaviye etkisinin araştırılması ve parenteral antibiyotik tedavisi uygulanan hastalarda tedavi etkinliği ve uygun tedavi süresi konusunda fikir sahibi olunmasıdır. Yöntemler: İstanbul Üniversitesi İstanbul Tıp Fakültesi, Deri ve Zührevi Hastalıkları Anabilim Dalı'nda, 2009-2014 yılları arasında yatırılarak tedavi edilen alt ekstremite selüliti tanılı 46 hastada enfeksiyon açısından olası risk faktörleri, yatış sırasında kullanılan tedaviler, sonuçları ve tedavi sonrası izlemeye alınan hastalarda nüks gelişimi retrospektif olarak değerlendirildi. Bulgular: Tinea pedis (n=19), diabetes mellitus (n=12), baypas cerrahisi (n=6) ve kronik lenfödem (n=5) risk faktörleri olarak saptandı. Takibi olmayan bir hasta dışındakilerin tümünde tam iyileşme saptandı. Hastaların 39'unda (%84,8) tek başına parenteral ampisilin-sulbaktam kullanıldı. İntravenöz antibiyotik tedavi süresi ortalama 17,7±12,4 gün (ortanca: 14 gün) olarak tespit edildi. Ortalama 2 yıllık izlem süresinde 11 hastada (%32,4) nüks saptandı ve tinea pedis ile nüks arasında anlamlı ilişki bulundu. Sonuç: Tinea pedis ve kronik lenfödem birden fazla atak oluşumunda risk faktörleri olarak saptandı. Parenteral antibiyotik tedavisi, bu amaçla da "tek başına ampisilin-sulbaktam" en sık kullanılan tedavi şekli olup alt ekstremite selülitinde çok yüksek oranda etkili bulundu. İyileşme için gerekli ortalama süre başka çalışmalara göre biraz uzun bulundu. Çalışmanın çoğunlukla dirençli ve komplike hastaların başvurduğu üçüncü basamak bir tedavi merkezinde gerçekleşmiş olması veya ülkemizdeki olası bir antibiyotik direnci bu sonuçta rol oynamış olabilir. Results: Tinea pedis (n=19), diabetes mellitus (n=12), by-pass surgery (n=6), and chronic lymphedema of the legs (n=5) were detected as main risk factors. Improvement with systemic therapy was seen in all patients except one patient who was lost to follow-up. Thirty nine of the patients (84.8%) were treated with parenteral ampicillin-sulbactam. The mean duration of parenteral antibiotic therapy was 17.7±12.4 (median: 14) days. In 11 patients (32.4%), recurrence was detected, during an average follow-up of 2 years. There was a significant correlation between tinea pedis and recurrence. Conclusion: Tinea pedis and chronic lymphedema were main risk factors for multiple attacks. Parenteral antibiotic treatment mostly used as the single drug regimen with ampicillinsulbactam was highly effective. Relatively longer duration of treatment in our patients has been attributed to the facts that being a tertiary medical center, dealing mostly with therapy resistant and high risk patients of cellulitis or antibiotic resistance in our country.

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“…1,2 In Taiwan, it is also a bothersome condition frequently encountered in our daily practice. 3 The clinical presentation can vary from an uncomplicated disease to an invasive infection, and once an invasive infection occurs, the mortality rate is as high as 18%.…”

Section: Introductionmentioning

confidence: 99%

The experience of intramuscular benzathine penicillin for prophylaxis of recurrent cellulitis: A cohort study

Chen

Liu

et al. 2017

Journal of Microbiology, Immunology and Infection

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Background/Purpose: Recurrent cellulitis is an important clinical issue but the optimal strategy for prophylaxis is not determined. Intramuscular benzathine penicillin at a 4-week interval had been adopted in our hospital and the study was conducted to evaluate the efficacy. Methods: From January 1, 2009 to May 31, 2013, all patients aged ! 18 year, with a history of recurrent cellulitis and having received at least three shots of intramuscular benzathine penicillin for prophylaxis were retrospectively recruited for analysis. Two treatment periods (prophylaxis period and nonprophylaxis period) were defined. The effects of benzathine penicillin prophylaxis and patient characteristics on the incidence rate of recurrent cellulitis were analyzed using Poisson regression model. Results: A total of 72 patients were enrolled, including 26 (36.1%) men. The most common underlying conditions were past surgery at the proximal side of the affected limb (38, 52.8%), malignancy (31, 43.1%), and diabetes mellitus (24, 33.3%). The incidence rate of recurrent cellulitis in the prophylaxis period was 0.73 episode/patient-year, significantly lower than that of 1.25 episodes/patient-year in the nonprophylaxis period (p < 0.001). Tinea pedis was a significant factor associated with increasing incidence of recurrent cellulitis in our cohort. Conclusion: Intramuscular benzathine penicillin at a 4-week interval may be an effective prophylactic strategy to reduce the incidence of cellulitis. Further studies are necessary to deter- mine the factors associated with failure of prophylaxis as well as optimal individualized dosage and dosing interval of the prophylactic agent.

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Antibiotic prophylaxis for preventing recurrent cellulitis: A systematic review and meta-analysis

Cited by 52 publications

References 30 publications

Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study

Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study

Retrospective Evaluation of Risk Factors and Response in Treatment among Hospitalized Patients with Lower-Extremity Cellulitis

The experience of intramuscular benzathine penicillin for prophylaxis of recurrent cellulitis: A cohort study

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