Retrospective Evaluation of Risk Factors and Response in Treatment among Hospitalized Patients with Lower-Extremity Cellulitis

Objective: To reveal the risk factors for lower-extremity cellulitis, to investigate the role of risk factors on the treatment, and to have knowledge about treatment efficiency and the optimal duration of therapy in patients on parenteral antibiotic therapy.\udMethods: Potential risk factors, therapies used during hospitalization, outcomes of therapies and follow-up data of 46 patients hospitalized in the Department of Dermatovenereology of İstanbul Medical Faculty of İstanbul University with lower-extremity cellulitis between years 2009 and 2014 were investigated retrospectively.\udResults: Tinea pedis (n=19), diabetes mellitus (n=12), by-pass surgery (n=6), and chronic lymphedema of the legs (n=5) were detected as main risk factors. Improvement with systemic therapy was seen in all patients except one patient who was lost to follow-up. Thirty nine of the patients (84.8%) were treated with parenteral ampicillin-sulbactam. The mean duration of parenteral antibiotic therapy was 17.7±12.4 (median: 14) days. In 11 patients (32.4%), recurrence was detected, during an average follow-up of 2 years. There was a significant correlation between tinea pedis and recurrence.\udConclusion: Tinea pedis and chronic lymphedema were main risk factors for multiple attacks. Parenteral antibiotic treatment mostly used as the single drug regimen with ampicillin-sulbactam was highly effective. Relatively longer duration of treatment in our patients has been attributed to the facts that being a tertiary medical center, dealing mostly with therapy resistant and high risk patients of cellulitis or antibiotic resistance in our country