ED management of cellulitis: A review of five urban centers

Dong, Sandy L.; Kelly, Karen D.; Oland, Ryan; Holroyd, Brian R.; Rowe, Brian H.

doi:10.1053/ajem.2001.28330

Cited by 81 publications

(81 citation statements)

References 14 publications

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“…Another retrospective review of five urban centers found 25 different treatment regimens among 416 patients with cellulitis. 22 Under half (46.5%) of patients in this study were initially treated with IV antibiotics as opposed to oral antibiotics (37.2%). This perhaps reflects a local treatment practice where there is a morning clinic available 7 days/week where patients receive IV antibiotics with daily reassessment by EPs.…”

Section: Discussionmentioning

confidence: 95%

“…19 A large retrospective epidemiologic study of cellulitis management reported a treatment failure rate of 13% and defined treatment failure as a change in or increased dose of antibiotics, addition of other agents, or relapse of infection. 22 One Canadian study of ED patients with cellulitis identified older patients (mean age = 59 years vs. 46 years, p = 0.02), prior antibiotic treatment, and the initial size of the infection as risk factors for treatment failure. 19 However, their sample size was small (n = 75) and they were unable to perform a multivariable regression analysis.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients With Uncomplicated Cellulitis

et al. 2014

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients With Uncomplicated Cellulitis

et al. 2014

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“…Acil servislere başvuru nedeni olan dermatolojik sorunlar içinde erizipel ve selülit en ön sıralarda yer almaktadır (7,8).…”

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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“…80% received daily OPAT (mainly with cefazolin) for an average of 4 days. In that study, 11% required a change of antibiotic therapy and 7% required admission [13]. Once-daily cefazolin with oral probenecid or daily ceftriaxone administered in the outpatient setting were found to be equivalent in a A c c e p t e d M a n u s c r i p t 14 randomised controlled trial in Australia (with 86% and 96% cure, respectively) and were associated with a mean of 6-7 days of OPAT [14].…”

Section: Of 24mentioning

confidence: 93%

Factors associated with outcome and duration of therapy in outpatient parenteral antibiotic therapy (OPAT) patients with skin and soft-tissue infections

Seaton¹,

Sharp²,

Bezlyak³

et al. 2011

International Journal of Antimicrobial Agents

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. Factors associated with outcome and duration of therapy in outpatient parenteral antibiotic therapy (OPAT) patients with skin and softtissue infections. International Journal of Antimicrobial Agents, Elsevier, 2011, 38 (3) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. SSTIs were observed; 84% were treated with daily ceftriaxone and 15% with teicoplanin (three daily loading doses then three times per week). Progression of infection was observed in 2.8% of cases, inpatient management was required in 6% and significant adverse events occurred in 7.1%. Overall OPAT success was 87.1%.Female sex, diabetes and treatment with teicoplanin were independently associated with OPAT failure. A significant reduction in duration of OPAT therapy was observed over time. A longer duration of intravenous therapy was associated with meticillinresistant Staphylococcus aureus (MRSA), older age, vascular disease, a diagnosis of bursitis, and treatment with teicoplanin. Non-inpatient referrals, management via a nurse-led patient group direction, and treatment with ceftriaxone were associated with reduced duration of OPAT. For selected patients with SSTIs, OPAT was generally safe and effective, but specific patient groups were identified with more complex management pathways and poorer outcomes.

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ED management of cellulitis: A review of five urban centers

Cited by 81 publications

References 14 publications

Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients With Uncomplicated Cellulitis

Predictors of Failure of Empiric Outpatient Antibiotic Therapy in Emergency Department Patients With Uncomplicated Cellulitis

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

Factors associated with outcome and duration of therapy in outpatient parenteral antibiotic therapy (OPAT) patients with skin and soft-tissue infections

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