Failure of antibiotics in cellulitis trials: a systematic review and meta-analysis

Obaitan, Itegbemie; Dwyer, Richard; Lipworth, Adam D.; Kupper, Thomas S.; Camargo, Carlos A.; Hooper, David C.; Murphy, Gëorge F.; Pallin, Daniel J.

doi:10.1016/j.ajem.2016.05.064

Cited by 16 publications

(10 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This has contributed to the annual hospitalization of approximately 900 000 patients across the United States for ABSSSI. 2 Globally, additional patients entering the health care system can contribute to ED overcrowding. This is a serious, growing concern because crowding delays patient care and worsens overall patient experience.…”

Section: Introductionmentioning

confidence: 99%

Dalbavancin Use in the Emergency Department Setting

et al. 2019

View full text Add to dashboard Cite

Background: Although dalbavancin’s (DBV’s) long half-life and one-time dosing strategy confer ideal administration in the ambulatory setting, the optimal role of DBV in the management of acute bacterial skin and skin structure infections (ABSSSIs) remains to be elucidated. Objectives: The primary objective of this study was to compare treatment outcomes of ABSSSI between patients who received DBV in the emergency department (ED) as part of standard care versus patients who received DBV as part of a telehealth program. Methods: This was a retrospective cohort study evaluating patients who received DBV at 3 urban EDs. The primary end point was the incidence of ABSSSI recurrence. Secondary outcomes included need for hospital admission and ED length of stay (LOS; in hours). Results: A total of 65 ABSSSI treatment courses were included; 42 were included in the telehealth criteria (TC) cohort and 23 in the initial criteria (IC) cohort. There were 14% (6/42) infection recurrences in the TC cohort and 22% (5/23) in the IC cohort, with median time to recurrence being 4 and 14 days, respectively. Median ED LOS was significantly shorter in the TC (5 vs 25 hours, P < 0.05). Numerically fewer individuals in the TC cohort required inpatient admission (0 vs n = 2, 9%). Conclusion and Relevance: Our results suggest that patients may be safely administered DBV in an ED setting, with telehealth follow-up. Providing structured patient selection criteria is an effective method of assisting ED providers in selecting appropriate DBV candidates to limit potential recurrences and readmissions.

show abstract

Section: Introductionmentioning

confidence: 99%

Dalbavancin Use in the Emergency Department Setting

et al. 2019

View full text Add to dashboard Cite

show abstract

“…This results in avoidable hospital admissions and unnecessary prescriptions of antibiotics . Definitive diagnostic criteria could potentially improve clinical care and also improve the validity of clinical research on cellulitis by ensuring appropriate case definition . However, there are currently no agreed diagnostic criteria for cellulitis.…”

mentioning

confidence: 99%

A systematic review showing the lack of diagnostic criteria and tools developed for lower‐limb cellulitis

et al. 2019

View full text Add to dashboard Cite

SummaryBackgroundCellulitis can be a difficult diagnosis to make. Furthermore, 31% of patients admitted from the emergency department with suspected lower‐limb cellulitis have been misdiagnosed, with incorrect treatment potentially resulting in avoidable hospital admission and the prescription of unnecessary antibiotics.ObjectivesWe sought to identify diagnostic criteria or tools that have been developed for lower‐limb cellulitis.MethodsWe conducted a systematic review using Ovid MEDLINE and Embase databases in May 2018, with the aim of describing diagnostic criteria and tools developed for lower‐limb cellulitis, and we assessed the quality of the studies identified using the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. We included all types of study that described diagnostic criteria or tools.ResultsEight observational studies were included. Five studies examined biochemical markers, two studies assessed imaging and one study developed a diagnostic decision model. All eight studies were considered to have a high risk for bias in at least one domain. The quantity and quality of available data was low and results could not be pooled owing to the heterogeneity of the findings.ConclusionsThere is a lack of high‐quality publications describing criteria or tools for diagnosing lower‐limb cellulitis. Future studies using prospective designs, validated in both primary and secondary care settings, are needed. What's already known about this topic? Diagnosing lower‐limb cellulitis on first presentation is challenging.Approximately one in three patients admitted from the emergency department with suspected lower‐limb cellulitis do not have cellulitis and are given another diagnosis on discharge. Consequently, this results in potentially avoidable hospital admissions and the prescription of unnecessary antibiotics.There are no diagnostic criteria available for lower‐limb cellulitis in the U.K. What does this study add? This systematic review has identified a key research gap in the diagnosis of lower‐limb cellulitis.There is a current lack of robustly developed and validated diagnostic criteria or tools for use in clinical practice.

show abstract

“…Odontogenic facial cellulitis is a bacterial infection of the facial tissues that can pose a significant risk to the patient [1]. Such cases are frequently encountered in odontology and oral surgery departments.…”

Section: Discussionmentioning

confidence: 99%

Complication of facial cellulitis: muscle hematoma after surgical treatment of complicated pericoronitis

Compain

Berquet

Loison-Robert

et al. 2018

J Oral Med Oral Surg

View full text Add to dashboard Cite

Observation: A 24-year-old man was referred to the dental emergency department for the management of a left submandibular cellulitis. The origin was a mandibular third molar. Drainage of the cellulitis and avulsion of the tooth were performed under general anesthesia. The follow-up was marked by a secondary infection of peri-zygomatic hematoma requiring a second drainage procedure. Discussion: The origin of the hematoma was a tear of the insertions of the mandibular elevators secondary to the trismus. The patient underwent two back-to-back general anesthesia procedures with tight trismus making induction and intubation difficult. Conclusion: A two-stage treatment with initial drainage and delayed avulsion after improvement of trismus is discussed.

show abstract

Failure of antibiotics in cellulitis trials: a systematic review and meta-analysis

Cited by 16 publications

References 35 publications

Dalbavancin Use in the Emergency Department Setting

Dalbavancin Use in the Emergency Department Setting

A systematic review showing the lack of diagnostic criteria and tools developed for lower‐limb cellulitis

Complication of facial cellulitis: muscle hematoma after surgical treatment of complicated pericoronitis

Contact Info

Product

Resources

About