(1) To determine antibiotic choices, route of administration, and outcomes of children treated as outpatients with noncomplicated, nonfacial cellulitis
at a tertiary care center. (2) To determine the number of visits and time spent in the emergency department (ED) for treatment
A descriptive case-control study.
A tertiary care pediatric ED at an academic medical center.
Medical records of all otherwise healthy children (aged 1-16 yrs) presenting with noncomplicated, nonfacial cellulitis
over a 3-year period (January 1, 2001-December 31, 2003) were reviewed. Data extracted included the following: demographics; clinical presentation; laboratory and microbiology results; management, including choice, dose, and route of antibiotic(s); treatment
failures; and time spent in the ED.
Two hundred sixty-nine patients met the inclusion criteria, and their charts were selected for review. The oral antibiotic most often prescribed was cephalexin (N = 105). Treatment
failure occurred in 10 (8.9%) of the cases. The intravenous antibiotic most often prescribed was cefazolin
(N = 124; 39 received cefazolin
alone, and 85 received cefazolin
). The cefazolin
-only group had 12 (31%) treatment
failures, whereas the cefazolin
group had 7 (8.1%) treatment
failures. More time in the ED (521 ± 287 minutes) and more visits (3.4 ± 2.8) were seen in the intravenous group as compared with the oral group (time in ED, 164 ± 139 minutes; visits, 1.4 ± 1).
Noncomplicated, nonfacial cellulitis
is most commonly treated using first-generation cephalosporins. Treatment
with oral antibiotics
was effective and required fewer visits and less time in the ED compared with intravenous treatment
. Twice-daily cefazolin
was associated with less treatment
failures and admissions than cefazolin
alone and may represent a reasonable alternative for children with nonfacial cellulitis
requiring intravenous antibiotics