Doub James B
Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Infect Chemother. 2022 Jun;54(2):382-387. doi: 10.3947/ic.2021.0095. Epub 2022 Jan 14.
Cellulitis is a common condition that plagues healthcare systems and is associated with significant healthcare costs and resource allocations. With ample antimicrobial therapy this infectious syndrome can be easily treated but recurrence is common. Many conditions predispose patients to be at risk for recurrent cellulitis with chronic lymphoedema being a significant risk factor secondary to pooling of lymphatic fluid and impaired local immune responses. Moreover, patients with chronic lymphoedema can be at risk for acute onset of severe cellulitis requiring urgent medical evaluation and treatment. Consequently, to prevent recurrent cellulitis episodes, the use of long-term oral antibiotics has been advocated, but when recurrences occur despite long-term antibiotic use limited options are available. In this case report, a unique treatment approach for preventing severe cellulitis is discussed with a pill in the pocket approach with the use of oral tedizolid. This has thwarted the need for recurrent hospitalizations and reduced health care costs for this individual patient. Herein this treatment approach is discussed as is the rationale for using tedizolid instead of other antibiotics.
蜂窝织炎是一种困扰医疗系统的常见病症，与高昂的医疗成本和资源分配相关。通过充足的抗菌治疗，这种感染综合征很容易得到治疗，但复发很常见。许多情况使患者易患复发性蜂窝织炎，慢性淋巴水肿是一个重要的危险因素，继发于淋巴液积聚和局部免疫反应受损。此外，慢性淋巴水肿患者可能有急性重症蜂窝织炎发作的风险，需要紧急医学评估和治疗。因此，为预防复发性蜂窝织炎发作，有人主张使用长期口服抗生素，但尽管长期使用抗生素仍有复发时，可用的选择有限。在本病例报告中，讨论了一种预防重症蜂窝织炎的独特治疗方法，即采用口服替地唑胺的“口袋药”方法。这避免了该个体患者反复住院的需要，并降低了医疗成本。本文将讨论这种治疗方法以及使用替地唑胺而非其他抗生素的理由。
