{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:48:06Z","timestamp":1792273686011,"version":"4.4.0"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,5,27]],"date-time":"2015-05-27T00:00:00Z","timestamp":1432684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Skin and soft tissue infections rank among the most frequent infections worldwide. Classic erysipelas is defined as a non\u2010purulent infection by beta\u2010hemolytic streptococci. The typical signs are tender, warm, bright erythema with tongue\u2010like extensions and early systemic symptoms such as fever or at least chills. Erysipelas always and best responds to penicillin.<\/jats:p><jats:p>Limited soft tissue infection or limited cellulitis are the terms we have introduced for infections frequently caused by <jats:italic>S. aureus<\/jats:italic> and often originating from chronic wounds or acute trauma. Clinically, they are marked by tender, erythematous swelling which, unlike erysipelas, exhibit a darker red hue and is not always accompanied by fever or chills at onset.<\/jats:p><jats:p>Severe cellulitis is a purulent, partially necrotic infection extending to the fascia, with general symptoms of infection, requiring surgical management in addition to antibiotics. It often fulfils criteria of so\u2010called complicated soft tissue infections according to the definition of the FDA, due to their frequent association with e.g. severe diabetes mellitus, peripheral arterial occlusive disease or severe immunosuppression. In contrast, the rare necrotizing skin and soft tissue infections represent a distinct entity, characterized by rapid progression to ischemic necroses and shock due to special bacterial toxins.<\/jats:p><jats:p>Limited cellulitis should be treated with cephalosporins group 1 or 2, or, when <jats:italic>S.aureus<\/jats:italic> is the isolated or highly likely causative agent, isoxazolyl\u2010penicillins (exploiting their minimal selection pressure on other bacteria). For severe cellulitis, initial antibiotic treatment (mostly iv) includes \u2013 depending on the location \u2010 agents also active against gram\u2010negative and\/or anaerobic bacteria. (e.g. clindamycine, aminopeniclilline with inhibitors of betalaktamase, fluochinolons, cephalosporines group 4).<\/jats:p><jats:p>For cutaneous abscesses, drainage presents the therapy of choice. Only under certain conditions additional antibiotic therapy is required.<\/jats:p><jats:p>Adherence to the diagnostic criteria and to evidence\u2010based or consensus\u2010derived treatment recommendations as presented herein should allow for an antibiotic therapy with a good balance of efficacy, tolerability by patients and low selection pressure for highly resistant bacteria.<\/jats:p>","DOI":"10.1111\/ddg.12721","type":"journal-article","created":{"date-parts":[[2015,5,28]],"date-time":"2015-05-28T12:18:20Z","timestamp":1432815500000},"page":"501-526","source":"Crossref","is-referenced-by-count":35,"title":["Frequent bacterial skin and soft tissue infections: diagnostic signs and treatment"],"prefix":"10.1111","volume":"13","author":[{"given":"Cord","family":"Sunderk\u00f6tter","sequence":"first","affiliation":[{"name":"Department of Dermatology University Hospital M\u00fcnster and Division of Infectious Diseases in Dermatology, University of M\u00fcnster"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Becker","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology University Hospital M\u00fcnster"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2011.11.016"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02353-09"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.12647"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70027-X"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-013-2743-6"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-013-2653-7"},{"key":"e_1_2_9_8_1","volume-title":"Mikrobiologisch\u2010infektiologische Qualit\u00e4tsstandards (MiQ 6a)","author":"Becker K","year":"2013"},{"key":"e_1_2_9_9_1","volume-title":"Mikrobiologisch\u2010infektiologische Qualit\u00e4tsstandards (MiQ 6b)","author":"Becker K","year":"2013"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-011-2255-1"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-013-2636-8"},{"key":"e_1_2_9_12_1","first-page":"CD003261","article-title":"Interventions for impetigo","volume":"1","author":"Koning S","year":"2012","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_9_13_1","volume-title":"Expertenkommission der Paul\u2010Ehrlich\u2010Gesellschaft f\u00fcr Chemotherapie eV Empfehlungen zur kalkulierten oralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen \u2013 Update 2015 GMS Infectious Diseases","author":"Sunderk\u00f6tter C","year":"2015"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/497143"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1086\/499365"},{"key":"e_1_2_9_16_1","first-page":"370","article-title":"[Comment on the contribution by P. H. Hoger: \u201cTopical antibiotics and antiseptics\u201d]","volume":"50","author":"Sunderk\u00f6tter C","year":"1999","journal-title":"Hautarzt"},{"key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1111\/j.1610-0387.2011.07786.x","article-title":"Diagnosis and treatment of Staphylococcus aureus infections of the skin and mucous membranes","volume":"9","author":"Sch\u00f6fer H","year":"2011","journal-title":"J Dtsch Dermatol Ges"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60841-2"},{"key":"e_1_2_9_19_1","first-page":"696","article-title":"Empfehlung zur Pr\u00e4vention und Kontrolle von Methicillin\u2010resistenten Staphylococcus\u2010aureus\u2010St\u00e4mmen (MRSA) in Krankenh\u00e4usern und anderen medizinischen Einrichtungen. Mitteilung der Kommission f\u00fcr Krankenhaushygiene und Infektionspr\u00e4vention am RKI","volume":"57","author":"Kommission f\u00fcr Krankenhaushygiene und Infektionspr\u00e4vention am RKI","year":"2014","journal-title":"Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz"},{"key":"e_1_2_9_20_1","volume-title":"Reisedermatosen","author":"Sunderk\u00f6tter C","year":"2015"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/02813439709018506"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-0997(2000)8:5<217::AID-IDOG1021>3.0.CO;2-1"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/43.suppl_2.83"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01645222"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1610-0387.2007.06287.x"},{"key":"e_1_2_9_26_1","first-page":"CD004299","article-title":"Interventions for cellulitis and erysipelas","author":"Kilburn SA","year":"2010","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1206300"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2014.02.011"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0399-077X(05)80579-7"},{"key":"e_1_2_9_30_1","first-page":"89","article-title":"Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies","volume":"65","author":"Koster JB","year":"2007","journal-title":"Neth J Med"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079906X148355"},{"key":"e_1_2_9_32_1","first-page":"225","volume-title":"Expertenkommission der Paul\u2010Ehrlich\u2010Gesellschaft f\u00fcr Chemotherapie e.V. Empfehlungen zur kalkulierten parenteralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen \u2013 Update","author":"Kujath P","year":"2010"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2004.019869"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1995.tb04742.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2053"},{"key":"e_1_2_9_36_1","first-page":"397","article-title":"[Community\u2010acquired methicillin\u2010resistant Staphylococcus aureus infections in children: multicenter trial]","volume":"106","author":"Paganini H","year":"2008","journal-title":"Arch Argent Pediatr"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-009-8468-x"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546630601165125"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.4065\/81.12.1553"},{"key":"e_1_2_9_40_1","first-page":"444","volume-title":"Therapie\u2010Handbuch Infektionskrankheiten (Sonderedition). 1. Auflage","author":"Becker K","year":"2013"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1086\/424846"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0707253"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2251"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2247"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr344"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-012-0367-x"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2009.03.014"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00377-07"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1086\/313971"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.03.002"}],"container-title":["JDDG: Journal der Deutschen Dermatologischen Gesellschaft"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fddg.12721","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fddg.12721","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.12721","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T12:20:17Z","timestamp":1696249217000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ddg.12721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,27]]},"references-count":49,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1111\/ddg.12721"],"URL":"https:\/\/doi.org\/10.1111\/ddg.12721","archive":["Portico"],"relation":{},"ISSN":["1610-0379","1610-0387"],"issn-type":[{"value":"1610-0379","type":"print"},{"value":"1610-0387","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5,27]]}}}