{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:16:52Z","timestamp":1747185412339,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cellulitis is a common acute skin and soft tissue infection that causes substantial morbidity and healthcare costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To audit the impact on cellulitis management, regimen tolerability and outcomes of switching from outpatient parenteral antimicrobial therapy (OPAT) using intravenous (i.v.) cefazolin once daily plus probenecid to oral beta\u2010lactam therapy (OBLT) using oral flucloxacillin plus probenecid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We undertook a retrospective audit on cellulitis management, regimen tolerability and outcomes at the Dunedin Public Hospital Emergency Department (ED) before and after a change of the local outpatient cellulitis treatment pathway from OPAT using i.v. cefazolin once daily plus probenecid to OBLT using oral flucloxacillin plus probenecid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>OPAT was used in 97\/123 (78.9%) patients with cellulitis before compared to 1\/70 (1.4%) after the pathway change (odds ratio (OR), 0.04, <jats:italic>P<\/jats:italic> &lt;\u20090.01). OBLT was used in 26\/123 (21.1%) patients with cellulitis before and 69\/70 (98.6%) after (OR, 218.8, <jats:italic>P<\/jats:italic> &lt;\u20090.01). Antimicrobial change due to intolerance occurred in 4\/123 (3.2%) patients with cellulitis before and 4\/70 (5.7%) after (OR, 1.8, <jats:italic>P<\/jats:italic>, not significant (NS)) the pathway change. Inpatient admission within 28\u2009days occurred in 15\/123 (12.2%) cellulitis patients before and 9\/70 (12.9%) after (OR, 1.1, <jats:italic>P<\/jats:italic>, NS) the pathway change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Implementation of a change in outpatient cellulitis treatment pathway resulted in a significant change in prescribing practice. Our findings suggest that OBLT was both tolerable and had similar outcomes to OPAT.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16173","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T07:16:21Z","timestamp":1689664581000},"page":"320-327","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral antimicrobial therapy for cellulitis versus outpatient parenteral antimicrobial therapy: a single\u2010centre audit of cellulitis outcomes"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9148-4837","authenticated-orcid":false,"given":"Thomas R.","family":"Bowhay","sequence":"first","affiliation":[{"name":"Dunedin Public Hospital Te Whatu Ora (Health New Zealand) Southern  Dunedin New Zealand"},{"name":"Centre for International Health University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany","family":"Tsang","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy C. Z.","family":"Wei","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wafa","family":"Edwik","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avi","family":"Fridman","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Hubber","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Y.","family":"Jo","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Mckay","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe","family":"Osmond\u2010Wallam","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Smythe","sequence":"additional","affiliation":[{"name":"Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Crump","sequence":"additional","affiliation":[{"name":"Centre for International Health University of Otago  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"Arnold","sequence":"additional","affiliation":[{"name":"Dunedin Public Hospital Te Whatu Ora (Health New Zealand) Southern  Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4955"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268809990483"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.18-2-160"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu296"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.54.3.358"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/420939"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2013.09.006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.23.5.731"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2019.09.004"},{"key":"e_1_2_7_11_1","unstructured":"ArnoldB LeuthauserA MurryA LimJ ReddingD.Outpatient Cellulitis Pathway [Internet]. 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