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dc.contributor.authorBruun, Tronden_US
dc.contributor.authorOppegaard, Oddvaren_US
dc.contributor.authorHufthammer, Karl Oveen_US
dc.contributor.authorLangeland, Ninaen_US
dc.contributor.authorSkrede, Steinaren_US
dc.description.abstractBackground: Skin and soft tissue infections are common reasons for medical care. Use of broad-spectrum therapy and costs have increased. Assessment of early treatment response has been given a central role both in clinical trials and everyday practice. However, there is a paucity of data on the dynamics of response, causes of early nonresponse, and how early nonresponse affects resource use and predicts outcome. Methods: We prospectively enrolled 216 patients hospitalized with cellulitis. Clinical and biochemical response data during the first 3 days of treatment were analyzed in relation to baseline factors, antibiotic use, surgery, and outcome. Multivariable analysis included logistic lasso regression. Results: Clinical or biochemical response was observed in the majority of patients the day after treatment initiation. Concordance between clinical and biochemical response was strongest at days 2 and 3. Female sex, cardiovascular disease, higher body mass index, shorter duration of symptoms, and cellulitis other than typical erysipelas were predictors of nonresponse at day 3. In contrast, baseline factors were not predictive of clinical failure assessed posttreatment. Among cases with antibiotic treatment escalation by day 2, 90% (37/41) had nonresponse at day 1, but only 5% (2/40) had inappropriate initial therapy. Nonresponse at day 3 was a predictor of treatment duration >14 days, but not of clinical failure. Conclusions: Nonpharmacological factors had a major impact on early response dynamics. Delayed response was rarely related to inappropriate therapy but strongly predictive of early treatment escalation, suggesting that broadening antibiotic treatment may often be premature.en_US
dc.publisherOxford University Presseng
dc.rightsAttribution-NonCommercial-NoDerivs CC BY-NC-NDeng
dc.subjectskin infectionseng
dc.subjectearly responseeng
dc.subjecttreatment failureeng
dc.titleEarly Response in Cellulitis: A Prospective Study of Dynamics and Predictorsen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright The Author 2016
dc.source.journalClinical Infectious Diseases

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Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivs CC BY-NC-ND