Risk factors for clinical failure in patients hospitalized with cellulitis and cutaneous abscess

Halilovic, Jenana; Brown, Jennifer

doi:10.1016/j.jinf.2012.03.013

Cited by 52 publications

(37 citation statements)

References 14 publications

(17 reference statements)

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“…It has, however, been shown as a strong risk factor for MRSA infection (both community and hospital acquired), which is a major cause of ATF. 33 Our findings build upon the studies conducted by Abdullahi et al 34 and Halilovic et al, 35 who demonstrated an association between BMI and H. pylori eradication success in an outpatient setting, as well as morbid obesity and cellulitis treatment failure in an in-patient setting, respectively. In the former study, patients with excess weight had a significantly lower eradication rate in comparison to the control group, while BMI was a significant predictor of H. pylori treatment failure (OR 1.06, 95% CI 1.01-1.11).…”

Section: Discussionsupporting

confidence: 79%

“…34 In the latter study, morbidly obese patients hospitalized for cellulitis, with or without MRSA, were significantly more likely to have clinical failure (OR 4.10), particularly if they were given a low oral dose of clindamycin or trimethoprim/sulfamethoxazole upon discharge. 35 In contrast to other studies investigating predictors of ATF, confounding variables, such as age, sex, comorbidity, heavy drinking or smoking, did not increase the risk for ATF. 17 In fact, non-drinkers had a 21% increased risk of ATF.…”

Section: Discussioncontrasting

confidence: 57%

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The effect of obesity on antibiotic treatment failure: a historical cohort study

Longo

Bartlett

MacGibbon

et al. 2013

Pharmacoepidemiology and Drug

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Section: Discussionsupporting

confidence: 79%

Section: Discussioncontrasting

confidence: 57%

The effect of obesity on antibiotic treatment failure: a historical cohort study

Longo

Bartlett

MacGibbon

et al. 2013

Pharmacoepidemiology and Drug

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“…Morbid obesity and antibiotics dosed at the lower end of guideline recommendations at discharge are known risk factors for treatment failure among patients hospitalized for cellulitis . The similar cephalexin treatment failure rates among morbidly obese and non‐obese patients were surprising and contrary to our hypothesis.…”

Section: Resultscontrasting

confidence: 97%

Evaluation of cephalexin failure rates in morbidly obese patients with cellulitis

et al. 2016

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“…Sixty-eight percent of patients were categorized as overweight, with BMIs ranging from 25 to 30 kg/m 2 , and 8% were categorized as obese, with BMIs greater than 30 kg/m 2 (20). A study suggested that TMP-SMX, a hydrophilic antibiotic, should be dosed on the basis of patients' total body weight due to insufficient concentrations and increased failure in obese patients (17,21). In a study by Halilovic et al, morbidly obese patients with cellulitis and/or abscess dosed with TMP-SMX as 1 double-strength tablet twice a day were more likely to fail treatment than were nonobese patients (21).…”

Section: Discussionmentioning

confidence: 99%

Obesity and Heart Failure as Predictors of Failure in Outpatient Skin and Soft Tissue Infections

Conway

Sellick

Kurtzhalts

et al. 2017

Antimicrob Agents Chemother

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The purpose of this study was to evaluate risk factors for failure of antibiotic treatment within 30 days for uncomplicated skin infections of outpatients treated in a Veterans Affairs hospital. A retrospective chart review of outpatients between January 2006 and July 2015 with an ICD-9 (International Statistical Classification of Diseases and Related Health Problems) code of cellulitis or abscess was included in the analysis. The primary outcome was success versus failure of the antibiotic, with failure defined as another antibiotic prescribed or hospitalization within 30 days for the original indication. A total of 293 patients were included in the final analysis, 24% of whom failed within 30 days. Obesity/ overweight (body mass index [BMI] of Ͼ25 kg/m 2 ) was identified in 83% of the overall population, with 16% of that population having a BMI greater than 40 kg/m 2 . An elevated mean BMI of 34.2 kg/m 2 (P ϭ 0.0098) was found in the subset of patients who failed oral antibiotics compared to a BMI of 31.32 kg/m 2 in patients who were treated successfully. Additionally, the patients who failed had an increased prevalence of heart failure at 16% (P ϭ 0.027). Using multivariate logistic regression, BMI and heart failure were determined to be significant predictors of antibiotic prescription failure. Each 10-kg/m 2 unit increase in BMI was associated with a 1.62-fold-greater odds of failure. A diagnosis of heart failure increased the odds of failure by 2.6-fold (range, 1.1-to 5.8-fold). Outpatients with uncomplicated skin infections with an elevated BMI and heart failure were found to have increased odds of failure, defined as hospitalization or additional antibiotics within 30 days.

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Risk factors for clinical failure in patients hospitalized with cellulitis and cutaneous abscess

Cited by 52 publications

References 14 publications

The effect of obesity on antibiotic treatment failure: a historical cohort study

The effect of obesity on antibiotic treatment failure: a historical cohort study

Evaluation of cephalexin failure rates in morbidly obese patients with cellulitis

Obesity and Heart Failure as Predictors of Failure in Outpatient Skin and Soft Tissue Infections

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