Antibiotics for Cellulitis: An Effective Clinical Guideline?

It is well known that antibiotics are overused. 

Source: cellulitispictures.com

A recently published article in the Archives of Internal Medicine reports how implementation of a clinical guideline in a hospital can positively affect management and outcome of complicated skin and soft tissue infection.

A total of 169 patients (66 with cellulitis, 103 with abscess) were included in the baseline cohort, and 175 (82 with cellulitis, 93 with abscess) were included in the intervention cohort. The intervention led to a significant decrease in use of microbiological cultures (80% vs 66%; P = .003) and fewer requests for inpatient consultations (46% vs 30%; P = .004). The duration of antibiotic therapy decreased from 13 days to 10 days (P < .001) and fewer patients received antimicrobial agents with broad aerobic gram-negative activity (66% vs 36%; P < .001), antipseudomonal activity (28% vs 18%; P = .02), or broad anaerobic activity (76% vs 49%; P < .001). No differences were observed in clinical failure (7% vs.7.4% of cases (P = .93). 

A major obstacle in changing clinical practice is obtaining quality data to support a change in practice.

This is a step in the right direction.