Management of Cellulitis in a Pediatric Emergency Department
Bibliographic record
Abstract
OBJECTIVES: (1) To determine antibiotic choices, route of administration, and outcomes of children treated as outpatients with noncomplicated, nonfacial cellulitis at a tertiary care center. (2) To determine the number of visits and time spent in the emergency department (ED) for treatment. DESIGN: A descriptive case-control study. SETTING: A tertiary care pediatric ED at an academic medical center. METHODS: Medical records of all otherwise healthy children (aged 1-16 yrs) presenting with noncomplicated, nonfacial cellulitis over a 3-year period (January 1, 2001-December 31, 2003) were reviewed. Data extracted included the following: demographics; clinical presentation; laboratory and microbiology results; management, including choice, dose, and route of antibiotic(s); treatment failures; and time spent in the ED. INTERVENTIONS: None. MAIN RESULTS: Two hundred sixty-nine patients met the inclusion criteria, and their charts were selected for review. The oral antibiotic most often prescribed was cephalexin (N = 105). Treatment failure occurred in 10 (8.9%) of the cases. The intravenous antibiotic most often prescribed was cefazolin (N = 124; 39 received cefazolin alone, and 85 received cefazolin and probenecid). The cefazolin-only group had 12 (31%) treatment failures, whereas the cefazolin and probenecid group had 7 (8.1%) treatment failures. More time in the ED (521 +/- 287 minutes) and more visits (3.4 +/- 2.8) were seen in the intravenous group as compared with the oral group (time in ED, 164 +/- 139 minutes; visits, 1.4 +/- 1). CONCLUSIONS: Noncomplicated, nonfacial cellulitis is most commonly treated using first-generation cephalosporins. Treatment with oral antibiotics was effective and required fewer visits and less time in the ED compared with intravenous treatment. Twice-daily cefazolin and probenecid was associated with less treatment failures and admissions than cefazolin alone and may represent a reasonable alternative for children with nonfacial cellulitis requiring intravenous antibiotics.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".