Antibiotic choice for cellulitis: Compliance with published guidelines

Background: Cellulitis is an infection of the skin and subcutaneous tissue presenting with erythema, swelling, warmth, and pain. It is a common cause of skin and soft tissue infections, resulting in 650,000 hospital admissions per year in the United States alone. Antibiotic choice during hospitalization and on discharge is complicated by increasing concern about antibiotic-resistant bacteria, resulting in use of anti-MRSA antibiotics or broad-spectrum antibiotics. The Infectious Diseases Society of America has published guidelines for management of cellulitis, though whether these guidelines are implemented in everyday practice is unknown.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research

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ConclusionsChildhood utilities derived from children or proxies are not interchangeable. The choice of self or proxy assessor may have potentially significant implications for economic evaluations of child health interventions.
Source: Social Science and Medicine - Category: Psychiatry & Psychology Source Type: research
Discussion/conclusionThe study hypothesis was confirmed: there were no differences according to primary versus secondary osteoarthritis in preoperative profile or results. Elbow osteoarthritis entails mechanical impingement. Arthroscopic debridement gave good results independently of primary or post-traumatic etiology.Level of evidenceIII, prospective comparative observational multicenter cohort study.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
​BY GREGORY TAYLOR, DO, &ERIC MCDOWELL, DOA 47-year-old woman presented to the emergency department with a chief complaint of pain and swelling on her left index finger two days after she was bitten by her cat. Her vitals were within normal limits. Physical exam was notable for two puncture wounds to the left index finger along the radial aspect of the middle phalanx. Fusiform swelling was noted around the proximal phalanx to the level of the MCP joint, with erythema extending to the distal palmar crease. The index finger was held in slight flexion with pain during passive extension and pain with palpation of the ten...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
​BY MARK GRANT, DO, &SARAH CARIGNAN, PA-CThe patient had been playing a round of golf a week earlier, and thought he had strained a muscle in his right lower back while swinging a golf club. The patient continued his golf workouts throughout the week, which included lifting weights and swinging a golf club with minimal pain.​The day prior to ED presentation, he began having worsening right-sided back pain, and began ibuprofen and ice treatment, which helped minimally. The patient woke up experiencing worsening back pain that radiated from his right flank to his right lower abdominal area. He reported increased pain...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
​BY AARON SNYDER, MDInfectious processes, such as streptococcal infections, can partially masquerade as alternative diagnosis. Streptococcal infections are a frequent source of infection treated by emergency physicians, and it is crucial that the appropriate tests, antibiotics, and hospitalization are used to recognize rash patterns and to identify causes and the differential of causation.A 60-year-old woman presented from her primary medical doctor's office with fever, fatigue, tachycardia, and facial discomfort for two days that developed into a malar rash. The patient reported one day of fever, several days of sore th...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Discussion Staphylococcus aureus is a gram-positive, catalase-positive coccal bacterium that is found on the skin and respiratory tract. It is the most common cause of skin and soft tissue abscesses. Staphylococcus can also cause enteritis, pneumonia, and toxic shock syndrome. In addition to abscesses, Staphylococcus can cause pustulosis, cellulitis, necrotizing fascitis and other exfoliative skin disease such as bullous impetigo. Staphylococcus is well-known to colonize the human skin, nail and nares. It is spread by physical contact and aerosolization. Skin breaches allow Staphylococcus to enter the body and to dissemin...
Source: - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Welcome to our new series, “Guts and Gore.” That title should serve as a warning that some of the videos we will use as teaching tools may be controversial and not for weak stomachs. We hope, however, that part of why you became an emergency provider was to handle sticky situations like the ones we will present. People like us have the ability to ignore blood and copious discharge, and instead focus on saving and improving the lives of our patients. Rarely are you thanked for this ability, and we hope this series on guts and gore will improve your technique, even when the going gets tough.   The Approach n...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
We present data from recently conducted research on the diagnosis and management of skin and soft tissue infections (SSTIs) in children. Recent findings: Current research in the area of SSTIs (cellulitis and abscess) has focused on the use of ultrasound, risk factors associated with bacteremia, antibiotic choice, and incision and drainage (I&D) practices. When clinical examination is equivocal at distinguishing abscess from cellulitis, ultrasound can aid in the diagnosis and alter management. Bacteremia is rare in immunocompetent children with uncomplicated SSTIs; blood cultures may be reserved for complicated cases and fo...
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean Klig and Clifford W. Bogue Source Type: research
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