{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:55:36Z","timestamp":1791982536682,"version":"4.4.0"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006356","name":"University of Southern Denmark","doi-asserted-by":"publisher","award":["17\/10636"],"award-info":[{"award-number":["17\/10636"]}],"id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006356","name":"University of Southern Denmark","doi-asserted-by":"publisher","award":["A583"],"award-info":[{"award-number":["A583"]}],"id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006356","name":"University of Southern Denmark","doi-asserted-by":"publisher","award":["20\/20505"],"award-info":[{"award-number":["20\/20505"]}],"id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Region of Southern Denmark","award":["17\/10636"],"award-info":[{"award-number":["17\/10636"]}]},{"name":"Region of Southern Denmark","award":["A583"],"award-info":[{"award-number":["A583"]}]},{"name":"Region of Southern Denmark","award":["20\/20505"],"award-info":[{"award-number":["20\/20505"]}]},{"name":"Hospital S\u00f8nderjylland","award":["17\/10636"],"award-info":[{"award-number":["17\/10636"]}]},{"name":"Hospital S\u00f8nderjylland","award":["A583"],"award-info":[{"award-number":["A583"]}]},{"name":"Hospital S\u00f8nderjylland","award":["20\/20505"],"award-info":[{"award-number":["20\/20505"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Cellulitis is a common infection in Emergency Departments (EDs), and unclear diagnostics may lead to unnecessary treatment with broad-spectrum antibiotics. The aim of this study was to characterize patients with cellulitis admitted to the ED, describe the type and route of antibiotic treatment and compare the prognosis for cellulitis to that for other infections. Methods: This multicenter, cross-sectional study prospectively included adult patients admitted to the ED suspected of having an infection. Data were collected from medical records, and an expert panel assigned a final diagnosis to each patient. Only patients diagnosed with an infection were included in this study. Results: A total of 777 patients were included, of which 77 were diagnosed with cellulitis. Diabetes, obesity and prior cellulitis were associated with cellulitis with an OR of 2.01 [95% CI: 1.17\u20133.46], OR 2.66 [95% CI: 1.54\u20134.59] and OR 14.88 [95% CI: 7.88\u201328.08], respectively. The majority of the patients were treated, according to the regional guidelines, with narrow-spectrum antibiotics. Broad-spectrum antibiotics were rarely used. The patients with cellulitis were hospitalized for a shorter time compared to those with other infections, but 26% were readmitted within 30 days. The 30-day mortality of the patients with cellulitis was 3.9% and did not differ significantly from other infections.<\/jats:p>","DOI":"10.3390\/antibiotics13111021","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T10:49:52Z","timestamp":1730285392000},"page":"1021","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Characteristics and Antibiotic Treatment of Patients with Cellulitis in the Emergency Department"],"prefix":"10.3390","volume":"13","author":[{"given":"Aaron K.","family":"Wiederhold","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, University of Southern Denmark, 5230 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0923-6960","authenticated-orcid":false,"given":"Mariana B.","family":"Cartuliares","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Jeppesen","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research, University of Southern Denmark, 6200 Aabenraa, Denmark"},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Southern Denmark, 6400 S\u00f8nderborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2236-6375","authenticated-orcid":false,"given":"Helene","family":"Skj\u00f8t-Arkil","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, 6200 Aabenraa, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/jgs.13836","article-title":"Infectious Disease-Related Emergency Department Visits of Elderly Adults in the United States, 2011\u20132012","volume":"64","author":"Goto","year":"2016","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"163.e1","DOI":"10.1016\/j.jaad.2012.03.024","article-title":"Lower limb cellulitis and its mimics: Part I. Lower limb cellulitis","volume":"67","author":"Hirschmann","year":"2012","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1001\/jama.2016.8825","article-title":"Cellulitis: A Review","volume":"316","author":"Raff","year":"2016","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"ofv181","DOI":"10.1093\/ofid\/ofv181","article-title":"Etiology of Cellulitis and Clinical Prediction of Streptococcal Disease: A Prospective Study","volume":"3","author":"Bruun","year":"2016","journal-title":"Open Forum Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2165\/00128071-200304030-00002","article-title":"Erysipelas: Recognition and management","volume":"4","author":"Bonnetblanc","year":"2003","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1086\/497127","article-title":"Risk factors for acute cellulitis of the lower limb: A prospective case-control study","volume":"41","author":"Gottfredsson","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1111\/bjd.15186","article-title":"Risk factors for nonpurulent leg cellulitis: A systematic review and meta-analysis","volume":"177","author":"Quirke","year":"2017","journal-title":"Br. J. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1017\/S095026880500484X","article-title":"Cellulitis incidence in a defined population","volume":"134","author":"Simonsen","year":"2006","journal-title":"Epidemiol. Infect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1086\/678056","article-title":"Antibiotic prescribing practices in a multicenter cohort of patients hospitalized for acute bacterial skin and skin structure infection","volume":"35","author":"Jenkins","year":"2014","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis","volume":"399","author":"Murray","year":"2022","journal-title":"Lancet"},{"key":"ref_11","unstructured":"DANMAP (2022). DANMAP 2022 Use of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Food Animals, Food and Humans in Denmark, Statens Serum Institut og Technical University of Denmark."},{"key":"ref_12","unstructured":"Ministry of Health (2024, June 13). One Health Strategy Against Antibiotic Resistance, Available online: https:\/\/www.ism.dk\/Media\/0\/D\/One%20health%20strategy%20mod%20antibiotikaresistens%20engelsk.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s10096-019-03490-6","article-title":"Adherence to antibiotic guidelines for erysipelas or cellulitis is associated with a favorable outcome","volume":"38","author":"Klotz","year":"2019","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Newman-Toker, D.E., Peterson, S.M., Badihian, S., Hassoon, A., Nassery, N., Parizadeh, D., Wilson, L.M., Jia, Y., Omron, R., and Tharmarajah, S. (2022). Diagnostic Errors in the Emergency Department: A Systematic Review.","DOI":"10.23970\/AHRQEPCCER258"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bl\u00e4ckberg, A., Trell, K., and Rasmussen, M. (2015). Erysipelas, a large retrospective study of aetiology and clinical presentation. BMC Infect. Dis., 15.","DOI":"10.1186\/s12879-015-1134-2"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.jinf.2010.03.014","article-title":"Risk stratification and outcome of cellulitis admitted to hospital","volume":"60","author":"Figtree","year":"2010","journal-title":"J. Infect."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.jinf.2020.07.030","article-title":"Route and duration of antibiotic therapy in acute cellulitis: A systematic review and meta-analysis of the effectiveness and harms of antibiotic treatment","volume":"81","author":"Cross","year":"2020","journal-title":"J. Infect."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1007\/s11606-018-4546-z","article-title":"Do Patients with Cellulitis Need to be Hospitalized? A Systematic Review and Meta-analysis of Mortality Rates of Inpatients with Cellulitis","volume":"33","author":"Gunderson","year":"2018","journal-title":"J. Gen. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Brink, A., Alsma, J., Verdonschot, R.J., Rood, P.P., Zietse, R., Lingsma, H.F., and Schuit, S.C. (2019). Predicting mortality in patients with suspected sepsis at the Emergency Department; A retrospective cohort study comparing qSOFA, SIRS and National Early Warning Score. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0211133"},{"key":"ref_20","first-page":"1372","article-title":"Evaluation of Multiple Imputation with Large Proportions of Missing Data: How Much Is Too Much?","volume":"50","author":"Lee","year":"2021","journal-title":"Iran. J. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e049606","DOI":"10.1136\/bmjopen-2021-049606","article-title":"Improved diagnostics of infectious diseases in emergency departments: A protocol of a multifaceted multicentre diagnostic study","volume":"11","author":"Heltborg","year":"2021","journal-title":"BMJ Open"},{"key":"ref_22","unstructured":"Danish Health Authority (2024, September 03). Sundhedsstyrelsens Udmeldinger om Alkohol. Available online: https:\/\/www.sst.dk\/da\/Viden\/Forebyggelse\/Alkohol\/Alkoholforebyggelse\/Sundhedsstyrelsens-udmeldinger-om-alkohol."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/11\/1021\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:24:04Z","timestamp":1760113444000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/11\/1021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,30]]},"references-count":22,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["antibiotics13111021"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics13111021","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,30]]}}}