A prospective study on erysipelas and infectious cellulitis: how are they dealt within hospital?

771 cases of erysipelas and 52 cases of infectious cellulitis were collecte d over 3 months in a prospective study carried out in French hospitals. The mean age was 62.7 +/- 19.3 years for the erysipelas patients and 69.7 +/- 16 years for the cellulitis patients. Sex-ratios were respectively 0.92 and 2.7 The infection was mainly localized in the lower limbs in both categori es (90.9% and 71%); the upper limbs and the face were more often involved i n cellulitis than in erysipelas (13% versus 5.2% and 10% versus 2.5%). Peni cillin G was the initial antimicrobial treatment in 45% of the erysipelas c ases, whereas amoxicillin-clavulanic acid was used in 32.7% of the cellulit is cases. Other antibiotics used were pristinamycin, antistaphylococcal pen icillin, and amoxicillin. Combinations of antibiotics were used to treat 50 % of the cellulitis cases but only 11% of the erysipelas cases. Anticoagula nts were used in 67.4% of the erysipelas cases and in 59.7% of the cellulit is cases. Surgery was performed in 52% of the cellulitis cases, and hyperba ric oxygen in 4.2%. The outcome was quite different for the 2 diseases: cur e rate without complications reached 86.6% for erysipelas; and only 48.1% f or cellulitis; death rates reached respectively 0.77% and 5.7%, median leng th of hospitalization 8 days and 21 days, and median length of antibiotic t reatment 15 days and 21 days. (C) 2000 Editions scientifiques et medicales Elsevier SAS.