blood cultures in complicated cellulitis?

20 Sep

Interesting article in August’s JEM, and the title says it all:

Blood culture results do not affect treatment in complicated cellulitis. (Paolo et al).

 

Click through to the pubmed link for the article.  Some highlights:

retrospective chart review, 639 adult patients (314 “complicated cellulitis”, 325 without comorbidities)

complicated cellulitis defined by

  • diabetes, (N=189)
  • active chemotherapy, (N=28)
  • dialysis, (N=19)
  • HIV/AIDS, (N=22)
  • organ transplantation (N=13)
  • PVD (N=24)
  • Hep B/C/cirrhosis (N=42)
  • other immunosuppression (N=49)

 

positive blood cultures:

  • complicated cellulitis 29/314
  • uncomplicated cellulitis 17/325

 

clinically significant change in management (change in class of antibiotic)

  • complicated cellulitis 6/314
  • uncomplicated cellulitis 4/325

 

THEIR CONCLUSION:

“Within this cohort of patients with complicated cellulitis, blood cultures rarely changed management from empirical coverage.”

 

References: the article; picture

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