Prospective evaluation of the management of moderate to severe cellulitis with parenteral antibiotics at a paediatric day treatment centre

J Paediatr Child Health. 2008 Apr;44(4):214-8. doi: 10.1111/j.1440-1754.2007.01236.x. Epub 2007 Oct 18.


Aim: To assess the clinical outcome of patients with moderate to severe cellulitis managed at a paediatric day treatment centre (DTC).

Methods: Prospective observational study of all patients (3 months to 18 years) with a presumed diagnosis of moderate to severe cellulitis made in a university-affiliated paediatric emergency department (ED) (September 2003 to September 2005). Patients treated at the DTC were given ceftriaxone or clindamycin.

Results: During the study period, a presumed diagnosis of moderate to severe cellulitis was made in 224 patients in the ED. Ninety-two patients were treated at the DTC (41%). The cellulitis had a median width of 7.0 cm (range: 1.0-50.0 cm) and a median length of 6.5 cm (range: 1.0-40.0 cm). Blood cultures were performed in 95.7%; one was positive for Staphylococcus aureus. After a mean of 2.5 days of intravenous therapy (first injection in the ED and a mean of 1.5 days at the DTC), 73 patients (79.3%) were successfully discharged from the DTC and switched to an oral agent. For these patients no relapse occurred. Nineteen patients (20.7%) required inpatient admission for further therapy. No patient was diagnosed with necrotizing fasciitis in the course of therapy. Seventy-eight satisfaction questionnaires were handed in and revealed very good to excellent parental satisfaction with treatment at the DTC in 94.8%.

Conclusion: Treatment with parenteral antibiotic at a DTC is a viable alternative to hospitalisation for moderate to severe cellulitis in children.

Publication types

  • Evaluation Study

MeSH terms

  • Administration, Oral
  • Adolescent
  • Ambulatory Care
  • Anti-Bacterial Agents / administration & dosage*
  • Ceftriaxone / administration & dosage
  • Cellulitis / blood
  • Cellulitis / drug therapy*
  • Cellulitis / microbiology
  • Cephalexin / administration & dosage
  • Child
  • Child Health Services
  • Child, Preschool
  • Clindamycin / administration & dosage
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Infusions, Parenteral
  • Male
  • Prospective Studies
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Clindamycin
  • Ceftriaxone
  • Cephalexin