Journal Club

IV Antibiotics: Focus on Cellulitis

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Instructions

Take Another Course

Post-Test

Objectives:

Upon completion of this course participants will be able to define cellulitis, identify two bacterial causes, and describe four key treatment guidelines according to the journal club authors.

In the US: Cellulitis is a common infection.

Cellulitis is a skin infection that spreads from the skin to underlying tissues. In severe cases, the infection can spread quickly, within hours or days. Infection may develop where the skin has been broken, such as by injury or infection. Cellulitis is caused by a bacterial infection.

Cellulitis can cause tenderness, pain, swelling, and redness at the site of the infection, and systemic signs of infection (fever/chills). In adults, infection usually occurs on the legs, face, or arms, but can occur on other areas. In children, infection can develop anywhere on the body.

Cellulitis can spread infection through the body quickly, resulting in bacteremia or sepsis. Other complications can develop such as thrombophlebitis or, rarely, gangrene, especially in older adults.

Treatment for cellulitis includes antibiotics, taken either orally or intravenously. It has been proven that in moderate-to-severe cases the treatment of choice is IV antibiotics [1]. This journal club will explore IV therapy regimes. The first study will look at the once-daily use of two cephalosporins in the treatment of cellulitis. The second study will examine the efficacy of continuous infusion of flucloxacillin in the home. This has traditionally been an in-hospital regimen due to the need for continuous infusion. With the advent of portable battery-operated infusion pumps and peripherally inserted central catheters (PICC) lines this regimen can now be delivered safely and more cost effectively in the home. A third study is included that nicely puts the concepts from the first two studies into practice. This study, actually a literature review, looks at the current practices and methodology in place for treating cellulitis, with the author's ideas for future study and research.

Treatment success in curing the infection along with treatment costs has been the focus of many recent studies in both Chemotherapy and Infectious Disease Journals.