Randomised controlled trial of intravenous antibiotic treatment for cellulitis at home compared with hospital
- PMID: 15604157
- PMCID: PMC544431
- DOI: 10.1136/bmj.38309.447975.EB
Randomised controlled trial of intravenous antibiotic treatment for cellulitis at home compared with hospital
Abstract
Objectives: To compare the efficacy, safety, and acceptability of treatment with intravenous antibiotics for cellulitis at home and in hospital.
Design: Prospective randomised controlled trial.
Setting: Christchurch, New Zealand.
Participants: 200 patients presenting or referred to the only emergency department in Christchurch who were thought to require intravenous antibiotic treatment for cellulitis and who did not have any contraindications to home care were randomly assigned to receive treatment either at home or in hospital.
Main outcome measures: Days to no advancement of cellulitis was the primary outcome measure. Days on intravenous and oral antibiotics, days in hospital or in the home care programme, complications, degree of functioning and pain, and satisfaction with site of care were also recorded.
Results: The two treatment groups did not differ significantly for the primary outcome of days to no advancement of cellulitis, with a mean of 1.50 days (SD 0.11) for the group receiving treatment at home and 1.49 days (SD 0.10) for the group receiving treatment in hospital (mean difference 0.01 days, 95% confidence interval -0.3 to 0.28). None of the other outcome measures differed significantly except for patients' satisfaction, which was greater in patients treated at home.
Conclusions: Treatment of cellulitis requiring intravenous antibiotics can be safely delivered at home. Patients prefer home treatment, but in this study only about one third of patients presenting at hospital for intravenous treatment of cellulitis were considered suitable for home treatment.
Figures
Comment in
-
Home based and hospital based IV antibiotics for cellulitis had similar effects on clinical outcomes.Evid Based Nurs. 2005 Jul;8(3):79. doi: 10.1136/ebn.8.3.79. Evid Based Nurs. 2005. PMID: 16021708 No abstract available.
References
-
- Nathwani D, Tice A. Ambulatory antimicrobial use: the value of an outcomes registry. J. Antimicrob. Chemother 2002;49: 149-54. - PubMed
-
- Grayson ML, Silvers J, Turnidge J. Home intravenous antibiotic therapy. A safe and effective alternative to inpatient care. Med J Aust 1995;162: 249-53. - PubMed
-
- Leder K, Turnidge JD, Grayson ML. Home-based treatment of cellulitis with twice-daily cefazolin. Med J Aust 1998;169: 519-22. - PubMed
-
- Montalto M, Dunt D. Home and hospital intravenous therapy for two acute infections: an early study. Aust N Z J Med 1997;27: 19-23. - PubMed
-
- Tice AD. Experience with a physician-directed, clinic-based program for outpatient parenteral antibiotic therapy in the USA. Eur J Clin Microbiol Infect Dis 1995;14: 655-61. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical