Who Fails Outpatient Therapy for Cellulitis?

More than 3% of U.S. emergency department (ED) visits are for skin infections, and about four out of five of these are cellulitis rather than abscess. Most patients with cellulitis are treated as outpatients, but prior research suggests that treatment is often unsuccessful.

Investigators studied predictors of treatment failure in patients with cellulitis receiving outpatient treatment at two Canadian academic EDs. Full follow-up was available for 499 patients, of whom 21% failed therapy (they required different antibiotics or hospital admission). Predictors of treatment failure were temperature >38°C at triage (odds ratio, 4.3), chronic leg ulcers (OR, 2.5), chronic edema or lymphedema (OR, 2.5), prior cellulitis in the same area (OR, 2.1), …