Literature DB >> 16189034

Emergency department management of home intravenous antibiotic therapy for cellulitis.

M Donald1, N Marlow, E Swinburn, M Wu.   

Abstract

OBJECTIVES: To evaluate the safety and efficacy of using intravenous cephazolin as a first line antibiotic for the treatment of cellulitis in a supervised outpatient programme.
METHODS: This study was a retrospective analysis and included all patients who attended the emergency department (ED) of a university affiliated hospital in Sydney over the period of 1 year and who satisfied the following inclusion criteria: (a) age >16 years, (b) presented with acute cellulitis, and (c) were suitable for home intravenous antibiotic therapy according to APAC guidelines.
RESULTS: In total, 124 patients were included, of whom 53 (42.7%) presented directly to the ED and 71 (57.3%) were referred by their general practitioner. Of these 124 patients, 75 (60.5%) were men and 49 (39.5%) were women. Age range was 16-97 years. There were 82 (66.2%) presentations of cellulitis of the lower limb, 30 (24.2%) of the upper limb, 9 (7.2%) of the face and 3 (2.4%) of the torso. Cephazolin 2 g twice daily was given to 123 (99.2%) of the patients, and one patient (0.8%) received ceftriaxone 2 g once daily. In total, 105 patients (84.7%) were treated successfully and 19 (15.3%) were re-admitted. Four of the unsuccessful treatment group required incision and drainage of abscesses. The mean duration of intravenous therapy was 6.24 days. One patient developed diarrhoea. There were no other complications attributable to therapy.
CONCLUSION: Low re-admission rates verify the efficacy of cephazolin 2 g twice daily in treating cellulitis in the home environment. Benefits are multiple and include economic savings and reduced risk of nosocomial infection.

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Year:  2005        PMID: 16189034      PMCID: PMC1726556          DOI: 10.1136/emj.2004.018143

Source DB:  PubMed          Journal:  Emerg Med J        ISSN: 1472-0205            Impact factor:   2.740


  7 in total

1.  International outpatient parenteral antimicrobial therapy.

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Journal:  Int J Clin Pract Suppl       Date:  2000-12

2.  Hospital in the home: take the evidence and run.

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3.  The management of skin and soft tissue infections: outpatient parenteral antibiotic therapy in the United Kingdom.

Authors:  D Nathwani
Journal:  Chemotherapy       Date:  2001       Impact factor: 2.544

4.  Ambulatory antimicrobial use: the value of an outcomes registry.

Authors:  Dilip Nathwani; Alan Tice
Journal:  J Antimicrob Chemother       Date:  2002-01       Impact factor: 5.790

5.  ED management of cellulitis: a review of five urban centers.

Authors:  S L Dong; K D Kelly; R C Oland; B R Holroyd; B H Rowe
Journal:  Am J Emerg Med       Date:  2001-11       Impact factor: 2.469

6.  Once-daily intravenous cefazolin plus oral probenecid is equivalent to once-daily intravenous ceftriaxone plus oral placebo for the treatment of moderate-to-severe cellulitis in adults.

Authors:  M Lindsay Grayson; Malcolm McDonald; Kimberley Gibson; Eugene Athan; Wendy J Munckhof; Phillip Paull; Fran Chambers
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7.  Hospital in the home: a randomised controlled trial.

Authors:  G A Caplan; J A Ward; N J Brennan; J Coconis; N Board; A Brown
Journal:  Med J Aust       Date:  1999-02-15       Impact factor: 7.738

  7 in total
  7 in total

1.  Outpatient parenteral antibiotic therapy in a suburban tertiary referral centre in Australia over 10 years.

Authors:  Wenlong Li; James Branley; Archana Sud
Journal:  Infection       Date:  2018-02-20       Impact factor: 3.553

2.  Outpatient management of moderate cellulitis in children using high-dose oral cephalexin.

Authors:  Evelyne D Trottier; Beatrice Farley St-Amand; Mélanie Vincent; Isabelle Chevalier; Julie Autmizguine; Stéphanie Tremblay; Serge Gouin
Journal:  Paediatr Child Health       Date:  2022-05-03       Impact factor: 2.600

Review 3.  Clinical and cost-effectiveness, safety and acceptability of community intravenous antibiotic service models: CIVAS systematic review.

Authors:  E D Mitchell; C Czoski Murray; D Meads; J Minton; J Wright; M Twiddy
Journal:  BMJ Open       Date:  2017-04-20       Impact factor: 2.692

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Authors:  Monica Chan; Chee Kheong Ooi; Joshua Wong; Lihua Zhong; David Lye
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Review 5.  Outpatient Parenteral Antimicrobial Therapy Among People Who Inject Drugs: A Review of the Literature.

Authors:  Joji Suzuki; Jennifer Johnson; Mary Montgomery; Margaret Hayden; Christin Price
Journal:  Open Forum Infect Dis       Date:  2018-08-07       Impact factor: 3.835

6.  Out Of Hospital And In Hospital Management Of Cellulitis Requiring Intravenous Therapy.

Authors:  Bin S Ong; Vincent Jiu Jong Ngian; Clarence Yeong; Caitlin Keighley
Journal:  Int J Gen Med       Date:  2019-11-29

7.  Lessons Learned From a Randomized Controlled Trial of Short-Course Intravenous Antibiotic Therapy for Erysipelas and Cellulitis of the Lower Limb (Switch Trial).

Authors:  Marcus C Clarke; Allen C Cheng; James Gd Pollard; Mark Birch; Raquel U Cowan; Jake A Linke; Aaron L Walton; N Deborah Friedman
Journal:  Open Forum Infect Dis       Date:  2019-07-20       Impact factor: 3.835

  7 in total

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