Is a serotonin–norepinephrine reuptake inhibitor superior to an SSRI in the treatment of major depressive disorder in adults?

Abstract

severe cellulitis of the extremities. Patients were excluded if they had lesions involving the trunk or neck, or if they had previously received antibiotics or wound debridement. Study endpoint was hospital discharge. Patients were further excluded from the study if they were discharged in less than 48 hours or if infection was mild enough to be treated with oral antibiotics before 48 hours. Necrotizing fasciitis was confirmed by operative findings and histopathology. Severe cellulitis was presumed where parenteral antibiotics were required for greater than 48 hours or when an abscess requiring debridement was present. A total of 825 patients met the criteria for severe cellulitis and 106 had pathology-proven necrotizing fasciitis.A LRINEC score was calculated for all patients included in the study with LRINEC scores greater than or equal to six having a sensitivity of 43% (95% CI, 0.34-0.53), a specificity of 83% (95% CI, 0.80-0.86), LR+ of 2.5, and LR2 of 0.69. For LRINEC scores greater than or equal to eight, sensitivity decreased to 27% (95% CI, 0.19-0.37), specificity increased to 93% (95% CI, 0.91-0.94), with LR+ of 3.9 and LR2 was 0.78. LRINEC showed poor performance with area under the receiveroperating characteristic curve for accuracy of 0.7 (95% CI, 0.64-0.75). This single-center study lacked confirmatory testing for severe cellulitis and limited evaluation to the extremities, reducing its generalizability.