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Published on: February 9, 2011
Skin and Soft Tissue Infections in Young Infants
Sheila Swartz1, Leah Cotter2, Anika Nelson2
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, sswartz@mcw.edu.
Introduction:
The management of young infants with skin and soft tissue infection is not well-defined.
Methods:
We performed a survey study of pediatric hospital medicine, emergency medicine, urgent care, and primary care physicians to assess the management of young infants with skin and soft tissue infection. The survey included 4 unique scenarios of a well-appearing infant with uncomplicated cellulitis of the calf with the combination of age ≤ 28 days vs 29-60 days and the presence vs absence of fever.
Results:
Of 229 surveys distributed, 91 were completed (40%). Hospital admission was chosen more often for younger infants (≤ 28 days) versus older infants regardless of fever status (45% vs 10% afebrile, 97% vs 38% febrile, both P < 0.001). Younger infants were more likely to get blood, urine, and cerebrospinal fluid studies (P < 0.01). Clindamycin was chosen in 23% of admitted younger infants compared to 41% of older infants (P < 0.05).
Conclusions:
Frontline pediatricians appear relatively comfortable with outpatient management of cellulitis in young infants and rarely pursued meningitis evaluation in any afebrile infants or older febrile infants.
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