A RANDOMIZED COMPARATIVE-STUDY OF ONCE-DAILY CEFTRIAXONE AND 6-HOURLYFLUCLOXACILLIN IN THE TREATMENT OF MODERATE TO SEVERE CELLULITIS - CLINICAL EFFICACY, SAFETY AND PHARMACOECONOMIC IMPLICATIONS

In a study comparing flucloxacillin (1g every 6 hours intravenously), as standard treatment for moderate to severe cellulitis, with ceftriax one (1g once daily intravenously), ceftriaxone was found to be an effe ctive alternative to flucloxacillin without the associated risk of ser ious cholestatic hepatitis. Forty-seven evaluable patients, 24 in the ceftriaxone group and 23 in the flucloxacillin group, were evaluated i n this prospective randomised study examining clinical efficacy, safet y and duration of hospitalisation. 22 of 23 (96%) patients in the ceft riaxone group achieved clinical success (clinical cure and improvement ), while 16 of 22 (70%) flucloxacillin patients were considered a clin ical success (clinical cure and improvement). Baseline bacteriology wa s not performed in the single patient who did not respond to ceftriaxo ne, while 5 of the 6 patients who did not respond to flucloxacillin ha d a negative baseline culture. The remaining flucloxacillin failure wa s infected with Staphylococcus aureus, which persisted at the post-tre atment evaluation. All other pathogens isolated at baseline in both tr eatment arms were eradicated at the post-treatment bacteriological eva luation. No serious or unexpected adverse events were reported in eith er group. Because it requires only once-daily administration, ceftriax one made it possible for some patients to be treated as outpatients, r esulting in an average reduction of 3.04 hospital bed-days, while at t he same time being as efficacious as flucloxacillin.