outpatient treatment failture in cellulitis

10 Mar

via an old NEJM Journal Watch recap:

QUICK HITS:

2 Canadian EDs

102/499 patients (21%) failed outpatient antibiotic therapy (needed different abx or admission)

predictors of treatment failure:

  • temp > 38°C at triage (OR = 4.3, 95% CI = 1.6 to 11.7)
  • chronic leg ulcers (OR = 2.5, 95% CI = 1.1 to 5.2)
  • chronic edema or lymphedema (OR = 2.5, 95% CI = 1.5 to 4.2)
  • prior cellulitis in the same area (OR = 2.1, 95% CI = 1.3 to 3.5)
  • cellulitis at a wound site (OR = 1.9, 95% CI = 1.2 to 3.0)

 

Makes sense.  Worth considering.  Good follow-up is key, also.

 

References: journal watch, original article; picture

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