Infectiologie, université de Nice-Sophia-Antipolis, hôpital de l'Archet 1, centre hospitalier universitaire de Nice, Nice, France.
Med Mal Infect. 2012 Oct;42(10):495-500. doi: 10.1016/j.medmal.2012.07.006. Epub 2012 Oct 6.
The medical dashboard (DB) recording our clinical practices indicated on one hand the use of two different diagnosis terms, acute dermohypodermitis (ADH) or cellulitis, and on the other hand, an important antibiotic prescription heterogeneity. Our aim was to define these two diagnosis groups and to document compliance to our antibiotic therapy protocol.
ADH and cellulitis were selected in our medical DB that records all patient data. Our local antibiotic therapy protocol was designed in April 2009; the prescription of recommended antibiotic agents defined the compliance to recommendations. The patient files indicating non-consensual therapy were analyzed to determine the reasons for inappropriate prescription.
Three hundred and four cases of ADH and 82 of cellulitis were diagnosed over 6.5years. ADH was associated with older age (P=0.007), a higher frequency of venous insufficiency (P=0.015), a lower frequency of cancer (P=0.007), and was more often located on lower limbs (P<0.001), compared to cellulitis. The diagnosis of ADH was associated with higher compliance to our antibiotic therapy protocol, compared to cellulitis: 68% versus (vs.) 24%, P<0.001, and after April 2009: 53% vs. 64%, P=0.033. Among the 162 inappropriate antibiotic prescriptions (42%), 75 were deemed justified after analyzing the patient file, but less frequently for ADH compared to cellulitis: 49% vs. 11,5%, P<0.001.
ADH presents different clinical characteristics compared to cellulitis. The antibiotic therapy protocol for ADH cannot be applied to cellulitis.
一方面，医疗仪表盘 (DB) 记录我们的临床实践表明使用了两种不同的诊断术语，急性皮肤皮下组织炎 (ADH) 或蜂窝织炎，另一方面，抗生素处方存在显著的异质性。我们的目的是定义这两种诊断组别，并记录我们的抗生素治疗方案的执行情况。
ADH 和蜂窝织炎是从记录所有患者数据的医疗 DB 中选择的。我们的局部抗生素治疗方案于 2009 年 4 月设计；推荐抗生素的处方定义了对建议的遵守情况。对指示非一致治疗的患者文件进行分析，以确定不适当处方的原因。
在 6.5 年期间，诊断了 304 例 ADH 和 82 例蜂窝织炎。ADH 与年龄较大（P=0.007）、静脉功能不全的频率较高（P=0.015）、癌症的频率较低（P=0.007）和更常位于下肢（P<0.001）相关，与蜂窝织炎相比。与蜂窝织炎相比，ADH 的诊断与更高的抗生素治疗方案的遵守率相关：68%对（vs.）24%，P<0.001，2009 年 4 月之后：53%对 64%，P=0.033。在 162 例不适当的抗生素处方（42%）中，分析患者文件后，有 75 例被认为是合理的，但 ADH 的比例低于蜂窝织炎：49%对 11.5%，P<0.001。
ADH 与蜂窝织炎相比具有不同的临床特征。ADH 的抗生素治疗方案不能应用于蜂窝织炎。
