Randomised controlled trial of intravenous antibiotic treatment for cellulitis at home compared with hospital.
OBJECTIVE
To compare the efficacy, safety, and acceptability of treatment with intravenous antibiotics for cellulitis at home and in hospital.


METHODS
Prospective randomised controlled trial.


METHODS
Christchurch, New Zealand.


METHODS
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.


METHODS
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.
Corwin
Paul
P
Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand. paul.corwin@chmeds.ac.nz
Toop
Les
L
McGeoch
Graham
G
Than
Martin
M
Wynn-Thomas
Simon
S
Wells
J Elisabeth
JE
Dawson
Robin
R
Abernethy
Paul
P
Pithie
Alan
A
Chambers
Stephen
S
Fletcher
Lynn
L
Richards
Dee
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002437:Cefazolin / Q000008:administration & dosage*; D002481:Cellulitis / Q000188:drug therapy*; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007262:Infusions, Intravenous; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010343:Patient Admission / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010360:Patient Transfer / Q000706:statistics & numerical data; D011446:Prospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002437:Cefazolin