Risk factors associated with a reduced response in the treatment of erysipelas
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Risk factors associated with a reduced response in the treatment of erysipelas. / Linke, Miriam; Booken, Nina.
in: J DTSCH DERMATOL GES, Jahrgang 13, Nr. 3, 03.2015, S. 217-25.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Risk factors associated with a reduced response in the treatment of erysipelas
AU - Linke, Miriam
AU - Booken, Nina
N1 - © 2015 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
PY - 2015/3
Y1 - 2015/3
N2 - BACKGROUND: In most cases, erysipelas may be adequately treated using first-line antibiotic therapy. However, clinicians are sometimes confronted with complicated cases, in which patients do not respond to initial antibiotic therapy. The objective of this study was to identify risk factors associated with a reduced response to antibiotic therapy and, thus, a more complicated disease course.PATIENTS AND METHODS: We retrospectively analyzed the clinical course of 98 patients with erysipelas treated with standard antibiotic therapy. Patient groups showing different therapeutic responses were compared with respect to clinical data, medical history, and laboratory parameters.RESULTS: Patients with bullous or hemorrhagic erysipelas (p = 0.0008), stasis dermatitis (p = 0.01) or chronic venous insufficiency (p = 0.0004) showed a significantly reduced response to initial therapy with cefuroxime or clindamycin, respectively. Furthermore, the response to initial therapy significantly depended on C-reactive protein (p = 0.007) and neutrophil (p = 0.02) levels.CONCLUSION: In erysipelas patients with clinical complications, abnormal laboratory parameters or preexisting local skin damage, an intensified antibiotic regimen should be considered.
AB - BACKGROUND: In most cases, erysipelas may be adequately treated using first-line antibiotic therapy. However, clinicians are sometimes confronted with complicated cases, in which patients do not respond to initial antibiotic therapy. The objective of this study was to identify risk factors associated with a reduced response to antibiotic therapy and, thus, a more complicated disease course.PATIENTS AND METHODS: We retrospectively analyzed the clinical course of 98 patients with erysipelas treated with standard antibiotic therapy. Patient groups showing different therapeutic responses were compared with respect to clinical data, medical history, and laboratory parameters.RESULTS: Patients with bullous or hemorrhagic erysipelas (p = 0.0008), stasis dermatitis (p = 0.01) or chronic venous insufficiency (p = 0.0004) showed a significantly reduced response to initial therapy with cefuroxime or clindamycin, respectively. Furthermore, the response to initial therapy significantly depended on C-reactive protein (p = 0.007) and neutrophil (p = 0.02) levels.CONCLUSION: In erysipelas patients with clinical complications, abnormal laboratory parameters or preexisting local skin damage, an intensified antibiotic regimen should be considered.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anti-Bacterial Agents/therapeutic use
KW - C-Reactive Protein/analysis
KW - Child
KW - Chronic Disease
KW - Comorbidity
KW - Drug Resistance, Bacterial
KW - Erysipelas/diagnosis
KW - Female
KW - Germany/epidemiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Neutrophils/pathology
KW - Prevalence
KW - Reproducibility of Results
KW - Retrospective Studies
KW - Risk Factors
KW - Sensitivity and Specificity
KW - Treatment Outcome
KW - Varicose Ulcer/epidemiology
KW - Venous Insufficiency/epidemiology
KW - Young Adult
U2 - 10.1111/ddg.12575
DO - 10.1111/ddg.12575
M3 - SCORING: Journal article
C2 - 25706926
VL - 13
SP - 217
EP - 225
JO - J DTSCH DERMATOL GES
JF - J DTSCH DERMATOL GES
SN - 1610-0379
IS - 3
ER -
