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JAC Advance Access originally published online on March 16, 2005
Journal of Antimicrobial Chemotherapy 2005 55(5):764-767; doi:10.1093/jac/dki092
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions{at}oupjournals.org

Antimicrobial practice

Nurse-led management of uncomplicated cellulitis in the community: evaluation of a protocol incorporating intravenous ceftriaxone

R. Andrew Seaton*, E. Bell, Y. Gourlay and L. Semple

Outpatient and Home Parenteral Antibiotic Service, Brownlee Centre Infection Unit, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK

* Corresponding author. Tel: +44-141-211-0292; Fax: +44-141-211-1097; Email: andrew.seaton{at}northglasgow.scot.nhs.uk

Objectives and methods: A management protocol for specialist nurses was developed for ambulatory management of uncomplicated cellulitis requiring initial intravenous (iv) antibiotic therapy. Patients were all managed through an outpatient parenteral antibiotic therapy (OPAT) service. Those with cellulitis were compared pre- and post-intervention.

Results: One hundred and fourteen patients were compared with 230 retrospective controls all managed through the OPAT service. Protocol management was associated with reduced duration of outpatient iv therapy from 4 to 3 days, P=0.02, and reduced need for physician review (100% to 19%). Outcomes, complications and readmissions were similar.

Conclusions: Specialist nurse-led management is safe and effective in the management of uncomplicated cellulitis in the context of an OPAT service and reduces the need for regular medical review without compromising clinical care.

Keywords: outpatient parenteral antibiotic therapy , intravenous antibiotic therapy , cellulitis , patient group direction , skin and soft tissue infections


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