PEDIATRICS Vol. 67 No. 6 June 1981, pp. 887-890
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Cellulitis: Treatment with Cefoxitin Compared with Multiple Antibiotic Therapy

José Ignacio Santos MD1, Jay A. Jacobson MD1, Paul Swensen MD1, and W. Martin Palmer MD1

1 Divisions of Infectious Diseases, Departments of Pediatrics and Medicine, University of Utah College of Medicine, Primary Children's Medical Center, and Latter Day Saints Hospital, Salt Lake City

Cefoxitin, a parenteral cephamycin beta-lactam antibiotic was prospectively evaluated as a single drug alternative in 31 children with cellulitis and the results of therapy were compared retrospectively with those from prevailing multiple antibiotic therapy for cellulitis in 56 children. Periorbital and lower extremity cellulitis accounted for more than 60% of the cases in both study groups. The most common bacterial agents included Haemophilus influenzae, Staphylococcus aureus, and group A beta-hemolytic Streptococcus. In as many as 50% of the cases, no etiologic agent could be found. In addition to blood cultures, cellulitis leading edge aspirate cultures were helpful in establishing the etiologic diagnosis. Of 52 patients sampled in the combined studies, 21% had positive aspirate cultures in the presence of negative blood cultures. The outcome and mean duration of hospital stay were similar in both groups. No severe adverse reactions were encountered. The mean number of antibiotics used in the retrospective study was three (range 1 to 7) whereas cefoxitin alone was used in the prospective study. All organisms isolated in the prospective study were susceptible to cefoxitin. Single antibiotic therapy with cefoxitin appears to be as safe and as effective in the treatment of cellulitis in children as multiple antibiotic therapy.

Submitted on May 27, 1980
Accepted on September 19, 1980