{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:40:08Z","timestamp":1746384008078,"version":"3.40.4"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>The aim of the study is to establish consensus recommendations on features used to determine the route of antibiotic administration and disposition for children with uncomplicated cellulitis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Modified Delphi methodology was performed with 2 rounds of confidential surveys of Emergency medicine and hospital medicine (HM) providers at Lurie Children's Hospital to assess cellulitis management in children (ages 6 months\u201318 years) without signs of sepsis or abscess formation. Using a 9-point Likert scale, emergency medicine providers ranked features by perceived level of importance when deciding initial antibiotic route and HM providers ranked features on importance when transitioning to oral antibiotics. Responses were grouped as not important (1\u20133), neutral (4\u20136), and important (7\u20139) and re-evaluated in the second round to reach consensus, defined as \u226570% agreement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Emergency medicine providers (n = 17) reached consensus on 15 of 16 features (93.8%), 10 deemed important. Participants reached greatest consensus (100%) on fevers\/chills, lymphangitis, and functional impairment as considerations for initiating intravenous antibiotics. HM providers (n = 15) reached consensus on 9 of 11 factors (81.8%), with 7 considered important when deciding on readiness for oral antibiotics. Providers indicated that stability, rather than reduction, of erythematous margins is sufficient to consider transition and de-escalation of therapy at less than 24 hours if all other clinical improvement criteria are met.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This study achieved consensus on important features for treatment and disposition of children with uncomplicated cellulitis in both emergency and inpatient contexts. These features have the potential to aid in decision making and improve standardization of clinical practice.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000003072","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T18:15:38Z","timestamp":1701281738000},"page":"913-917","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Management of Children With Uncomplicated Cellulitis in Emergency and Hospital Settings"],"prefix":"10.1097","volume":"39","author":[{"given":"Grace","family":"St. Cyr","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxwell","family":"McMahon","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A.","family":"Florin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Verre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wee-Jhong","family":"Chua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1017\/S1481803500014342","article-title":"Treatment failure in emergency department patients with cellulitis","volume":"7","year":"2005","journal-title":"CJEM"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1001\/jama.2016.8825","article-title":"Cellulitis: a review","volume":"316","year":"2016","journal-title":"JAMA"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"e20181420","DOI":"10.1542\/peds.2018-1420","article-title":"Development and validation of a cellulitis risk score: the Melbourne ASSET score","volume":"143","year":"2019","journal-title":"Pediatrics"},{"key":"bib5-20250504","first-page":"1","article-title":"The Delphi technique: making sense of consensus","volume":"12","year":"2007","journal-title":"Pract Assess Res Eval"},{"year":"2001","key":"bib6-20250504","first-page":"1"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"116","DOI":"10.5662\/wjm.v11.i4.116","article-title":"Delphi methodology in healthcare research: how to decide its appropriateness","volume":"11","year":"2021","journal-title":"World J Methodol"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research Electronic Data Capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","year":"2009","journal-title":"J Biomed Inform"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","year":"2019","journal-title":"J Biomed Inform"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1093\/cid\/ciu444","article-title":"Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America","volume":"59","year":"2014","journal-title":"Clin Infect Dis"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1093\/jac\/dkq362","article-title":"Severity assessment of skin and soft tissue infections: cohort study of management and outcomes for hospitalized patients","volume":"66","year":"2011","journal-title":"J Antimicrob Chemother"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1093\/cid\/ciq146","article-title":"Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children","volume":"52","year":"2011","journal-title":"Clin Infect Dis"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1086\/511033","article-title":"Clinical and epidemiologic characteristics cannot distinguish community-associated methicillin-resistant Staphylococcus aureus infection from methicillin-susceptible S. aureus infection: a prospective investigation","volume":"44","year":"2007","journal-title":"Clin Infect Dis"},{"key":"bib15-20250504","first-page":"904","article-title":"Clinical practice. 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