Inaoki Makoto, Inaoki Asako, Nishijima Chihiro
Department of Dermatology, National Hospital Organization Kanazawa Medical Center, 1-1 Shimoishibiki-machi, Kanazawa 920-8650, Japan.
Faculty of Culture and Information Science, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto 610-0394, Japan.
J Infect Chemother. 2018 Apr;24(4):256-261. doi: 10.1016/j.jiac.2017.11.005. Epub 2017 Dec 15.
The recommended duration of antibiotic therapy for patients hospitalized with cellulitis is 5-14 days. However, factors that affect the duration of treatment have rarely been examined.
We conducted an observation study in a regional hospital in Japan to examine factors that affect the duration of antibiotic therapy for cellulitis. Our study included 102 patients with cellulitis of the lower extremities who were treated with intravenous cefazolin alone. Intravenous cefazolin was terminated when redness, swelling, and tenderness of the lower extremities disappeared, and subsequently the patients were discharged. The relationship between the duration (days) of treatment with intravenous cefazolin (DIVC) and clinical factors were analyzed.
The median DIVC was 8 days (interquartile range, 7-10 days). On univariate analysis, DIVC correlated significantly with patient age (P = 0.0071) and with C-reactive protein levels before treatment (P = 0.0053). DIVC in patients with diabetes mellitus was significantly longer than that in patients without diabetes mellitus (P = 0.0033). DIVC in patients with blood stream infection was significantly longer than that in patients without blood stream infection (P = 0.029). On multivariate analysis, variables independently associated with longer DIVC included patient age (P = 0.044), C-reactive protein levels before treatment (P = 0.017), presence of diabetes mellitus (P = 0.0021), and presence of blood stream infection (P = 0.028).
Duration of treatment with intravenous antibiotics for cellulitis is associated with patient age, C-reactive protein levels, coexisting diabetes mellitus, and coexisting blood stream infection. These findings should be considered when treatment plans for cellulitis are devised.
蜂窝织炎住院患者抗生素治疗的推荐疗程为5 - 14天。然而，影响治疗疗程的因素鲜有研究。
我们在日本一家地区医院开展了一项观察性研究，以探究影响蜂窝织炎抗生素治疗疗程的因素。我们的研究纳入了102例仅接受静脉注射头孢唑林治疗的下肢蜂窝织炎患者。当下肢的红肿和压痛消失时停止静脉注射头孢唑林，随后患者出院。分析了静脉注射头孢唑林的治疗疗程（天数）与临床因素之间的关系。
静脉注射头孢唑林的中位疗程为8天（四分位间距，7 - 10天）。单因素分析显示，静脉注射头孢唑林的疗程与患者年龄显著相关（P = 0.0071），与治疗前C反应蛋白水平显著相关（P = 0.0053）。糖尿病患者静脉注射头孢唑林的疗程显著长于非糖尿病患者（P = 0.0033）。血流感染患者静脉注射头孢唑林的疗程显著长于无血流感染患者（P = 0.029）。多因素分析显示，与静脉注射头孢唑林疗程较长独立相关的变量包括患者年龄（P = 0.044）、治疗前C反应蛋白水平（P = 0.017）、糖尿病的存在（P = 0.0021）和血流感染的存在（P = 0.028）。
蜂窝织炎静脉用抗生素的治疗疗程与患者年龄、C反应蛋白水平、并存的糖尿病及并存的血流感染有关。制定蜂窝织炎治疗方案时应考虑这些发现。
