Oral antimicrobial therapy for cellulitis versus outpatient parenteral antimicrobial therapy: a single‐centre audit of cellulitis outcomes

Background Cellulitis is a common acute skin and soft tissue infection that causes substantial morbidity and healthcare costs. Aims To audit the impact on cellulitis management, regimen tolerability and outcomes of switching from outpatient parenteral antimicrobial therapy (OPAT) using intravenous (...

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Published in:Internal medicine journal 2024-02, Vol.54 (2), p.320-327
Main Authors: Bowhay, Thomas R., Tsang, Tiffany, Wei, Jeremy C. Z., Edwik, Wafa, Fridman, Avi, Hubber, Julia, Jo, Jae Y., Mckay, Nicole, O'Brien, Catherine, Osmond‐Wallam, Joe, Smythe, James, Crump, John A., Arnold, Brendan
Format: Article
Language:English
Subjects:
antibiotic
antibiotic guidelines
antimicrobial stewardship
Cefazolin
Cellulitis
Emergency medical care
Flucloxacillin
Morbidity
outpatient
Patients
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Summary:Background Cellulitis is a common acute skin and soft tissue infection that causes substantial morbidity and healthcare costs. Aims To audit the impact on cellulitis management, regimen tolerability and outcomes of switching from outpatient parenteral antimicrobial therapy (OPAT) using intravenous (i.v.) cefazolin once daily plus probenecid to oral beta‐lactam therapy (OBLT) using oral flucloxacillin plus probenecid. Methods We undertook a retrospective audit on cellulitis management, regimen tolerability and outcomes at the Dunedin Public Hospital Emergency Department (ED) before and after a change of the local outpatient cellulitis treatment pathway from OPAT using i.v. cefazolin once daily plus probenecid to OBLT using oral flucloxacillin plus probenecid. Results OPAT was used in 97/123 (78.9%) patients with cellulitis before compared to 1/70 (1.4%) after the pathway change (odds ratio (OR), 0.04, P
ISSN:1444-0903
1445-5994
DOI:10.1111/imj.16173