Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children: an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment

Italian Pediatric Infectious Diseases Society, the Italian Pediatric Dermatology Society, Luisa Galli, Elisabetta Venturini, Andrea Bassi, Guido Castelli Gattinara, Elena Chiappini, Claudio Defilippi, Andrea Diociaiuti, Susanna Esposito, Silvia Garazzino, Antonietta Giannattasio, Andrzej Krzysztofiak, Stefano Latorre, Andrea Lo Vecchio, Paola Marchisio, Carlotta Montagnani, Giangiacomo Nicolini, Andrea Novelli, Gian Maria RossoliniChiara Tersigni, Alberto Villani, May El Hachem, Iria Neri

Research output: Contribution to journalReview article

Abstract

Purpose: The main objective of this article was to offer practical suggestions, given the existing evidence, for identifying and managing bacterial impetigo, abscess, and cellulitis in ambulatory and hospital settings. Methods: Five Italian pediatric societies appointed a core working group. In selected conditions, specially trained personnel evaluated quality assessment of treatment strategies according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Only randomized controlled trials (RCTs) and observational studies were included for quality assessment according to the GRADE methodology. MEDLINE, Ovid MEDLINE, EMBASE, and Cochrane Library databases were searched with a strategy combining MeSH and free text terms. Findings: The literature review included 364 articles focusing on impetigo, skin abscess, and cellulitis/orbital cellulitis. The articles included for quality assessment according to the GRADE methodology for impetigo comprised 5 RCTs and 1 observational study; for skin abscess, 10 RCTs and 3 observational studies were included; for cellulitis and erysipelas, 5 RCTs and 5 observational studies were included; and for orbital cellulitis, 8 observational studies were included. Recommendations were formulated according to 4 grades of strength for each specific topic (impetigo, skin abscesses, cellulitis, and orbital cellulitis). Where controversies arose and expert opinion was considered fundamental due to lack of evidence, agreement according to Delphi consensus recommendations was included. Implications: Based on a literature review and on local epidemiology, this article offers practical suggestions for use in both ambulatory and hospital settings for managing the most common bacterial SSTIs.

Original languageEnglish
Pages (from-to)532-551.e17
JournalClinical Therapeutics
Volume41
Issue number3
DOIs
Publication statusPublished - Mar 1 2019

Fingerprint

Impetigo
Soft Tissue Infections
Cellulitis
Abscess
Orbital Cellulitis
Observational Studies
Randomized Controlled Trials
Skin
MEDLINE
Erysipelas
Therapeutics
Expert Testimony
Libraries
Epidemiology
Databases
Pediatrics

Keywords

  • abscess
  • cellulitis
  • children
  • impetigo
  • treatment

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Italian Pediatric Infectious Diseases Society, the Italian Pediatric Dermatology Society, Galli, L., Venturini, E., Bassi, A., Gattinara, G. C., ... Neri, I. (2019). Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children: an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment. Clinical Therapeutics, 41(3), 532-551.e17. https://doi.org/10.1016/j.clinthera.2019.01.010

Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children : an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment. / Italian Pediatric Infectious Diseases Society; the Italian Pediatric Dermatology Society; Galli, Luisa; Venturini, Elisabetta; Bassi, Andrea; Gattinara, Guido Castelli; Chiappini, Elena; Defilippi, Claudio; Diociaiuti, Andrea; Esposito, Susanna; Garazzino, Silvia; Giannattasio, Antonietta; Krzysztofiak, Andrzej; Latorre, Stefano; Lo Vecchio, Andrea; Marchisio, Paola; Montagnani, Carlotta; Nicolini, Giangiacomo; Novelli, Andrea; Rossolini, Gian Maria; Tersigni, Chiara; Villani, Alberto; El Hachem, May; Neri, Iria.

In: Clinical Therapeutics, Vol. 41, No. 3, 01.03.2019, p. 532-551.e17.

Research output: Contribution to journalReview article

Italian Pediatric Infectious Diseases Society, the Italian Pediatric Dermatology Society, Galli, L, Venturini, E, Bassi, A, Gattinara, GC, Chiappini, E, Defilippi, C, Diociaiuti, A, Esposito, S, Garazzino, S, Giannattasio, A, Krzysztofiak, A, Latorre, S, Lo Vecchio, A, Marchisio, P, Montagnani, C, Nicolini, G, Novelli, A, Rossolini, GM, Tersigni, C, Villani, A, El Hachem, M & Neri, I 2019, 'Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children: an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment', Clinical Therapeutics, vol. 41, no. 3, pp. 532-551.e17. https://doi.org/10.1016/j.clinthera.2019.01.010
Italian Pediatric Infectious Diseases Society, the Italian Pediatric Dermatology Society, Galli L, Venturini E, Bassi A, Gattinara GC et al. Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children: an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment. Clinical Therapeutics. 2019 Mar 1;41(3):532-551.e17. https://doi.org/10.1016/j.clinthera.2019.01.010
Italian Pediatric Infectious Diseases Society ; the Italian Pediatric Dermatology Society ; Galli, Luisa ; Venturini, Elisabetta ; Bassi, Andrea ; Gattinara, Guido Castelli ; Chiappini, Elena ; Defilippi, Claudio ; Diociaiuti, Andrea ; Esposito, Susanna ; Garazzino, Silvia ; Giannattasio, Antonietta ; Krzysztofiak, Andrzej ; Latorre, Stefano ; Lo Vecchio, Andrea ; Marchisio, Paola ; Montagnani, Carlotta ; Nicolini, Giangiacomo ; Novelli, Andrea ; Rossolini, Gian Maria ; Tersigni, Chiara ; Villani, Alberto ; El Hachem, May ; Neri, Iria. / Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children : an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment. In: Clinical Therapeutics. 2019 ; Vol. 41, No. 3. pp. 532-551.e17.
@article{52df1daf290343beb68547cbfabb2565,
title = "Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children: an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment",
abstract = "Purpose: The main objective of this article was to offer practical suggestions, given the existing evidence, for identifying and managing bacterial impetigo, abscess, and cellulitis in ambulatory and hospital settings. Methods: Five Italian pediatric societies appointed a core working group. In selected conditions, specially trained personnel evaluated quality assessment of treatment strategies according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Only randomized controlled trials (RCTs) and observational studies were included for quality assessment according to the GRADE methodology. MEDLINE, Ovid MEDLINE, EMBASE, and Cochrane Library databases were searched with a strategy combining MeSH and free text terms. Findings: The literature review included 364 articles focusing on impetigo, skin abscess, and cellulitis/orbital cellulitis. The articles included for quality assessment according to the GRADE methodology for impetigo comprised 5 RCTs and 1 observational study; for skin abscess, 10 RCTs and 3 observational studies were included; for cellulitis and erysipelas, 5 RCTs and 5 observational studies were included; and for orbital cellulitis, 8 observational studies were included. Recommendations were formulated according to 4 grades of strength for each specific topic (impetigo, skin abscesses, cellulitis, and orbital cellulitis). Where controversies arose and expert opinion was considered fundamental due to lack of evidence, agreement according to Delphi consensus recommendations was included. Implications: Based on a literature review and on local epidemiology, this article offers practical suggestions for use in both ambulatory and hospital settings for managing the most common bacterial SSTIs.",
keywords = "abscess, cellulitis, children, impetigo, treatment",
author = "{Italian Pediatric Infectious Diseases Society} and {the Italian Pediatric Dermatology Society} and Luisa Galli and Elisabetta Venturini and Andrea Bassi and Gattinara, {Guido Castelli} and Elena Chiappini and Claudio Defilippi and Andrea Diociaiuti and Susanna Esposito and Silvia Garazzino and Antonietta Giannattasio and Andrzej Krzysztofiak and Stefano Latorre and {Lo Vecchio}, Andrea and Paola Marchisio and Carlotta Montagnani and Giangiacomo Nicolini and Andrea Novelli and Rossolini, {Gian Maria} and Chiara Tersigni and Alberto Villani and {El Hachem}, May and Iria Neri",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.clinthera.2019.01.010",
language = "English",
volume = "41",
pages = "532--551.e17",
journal = "Clinical Therapeutics",
issn = "0149-2918",
publisher = "Excerpta Medica Inc.",
number = "3",

}

TY - JOUR

T1 - Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children

T2 - an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment

AU - Italian Pediatric Infectious Diseases Society

AU - the Italian Pediatric Dermatology Society

AU - Galli, Luisa

AU - Venturini, Elisabetta

AU - Bassi, Andrea

AU - Gattinara, Guido Castelli

AU - Chiappini, Elena

AU - Defilippi, Claudio

AU - Diociaiuti, Andrea

AU - Esposito, Susanna

AU - Garazzino, Silvia

AU - Giannattasio, Antonietta

AU - Krzysztofiak, Andrzej

AU - Latorre, Stefano

AU - Lo Vecchio, Andrea

AU - Marchisio, Paola

AU - Montagnani, Carlotta

AU - Nicolini, Giangiacomo

AU - Novelli, Andrea

AU - Rossolini, Gian Maria

AU - Tersigni, Chiara

AU - Villani, Alberto

AU - El Hachem, May

AU - Neri, Iria

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Purpose: The main objective of this article was to offer practical suggestions, given the existing evidence, for identifying and managing bacterial impetigo, abscess, and cellulitis in ambulatory and hospital settings. Methods: Five Italian pediatric societies appointed a core working group. In selected conditions, specially trained personnel evaluated quality assessment of treatment strategies according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Only randomized controlled trials (RCTs) and observational studies were included for quality assessment according to the GRADE methodology. MEDLINE, Ovid MEDLINE, EMBASE, and Cochrane Library databases were searched with a strategy combining MeSH and free text terms. Findings: The literature review included 364 articles focusing on impetigo, skin abscess, and cellulitis/orbital cellulitis. The articles included for quality assessment according to the GRADE methodology for impetigo comprised 5 RCTs and 1 observational study; for skin abscess, 10 RCTs and 3 observational studies were included; for cellulitis and erysipelas, 5 RCTs and 5 observational studies were included; and for orbital cellulitis, 8 observational studies were included. Recommendations were formulated according to 4 grades of strength for each specific topic (impetigo, skin abscesses, cellulitis, and orbital cellulitis). Where controversies arose and expert opinion was considered fundamental due to lack of evidence, agreement according to Delphi consensus recommendations was included. Implications: Based on a literature review and on local epidemiology, this article offers practical suggestions for use in both ambulatory and hospital settings for managing the most common bacterial SSTIs.

AB - Purpose: The main objective of this article was to offer practical suggestions, given the existing evidence, for identifying and managing bacterial impetigo, abscess, and cellulitis in ambulatory and hospital settings. Methods: Five Italian pediatric societies appointed a core working group. In selected conditions, specially trained personnel evaluated quality assessment of treatment strategies according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Only randomized controlled trials (RCTs) and observational studies were included for quality assessment according to the GRADE methodology. MEDLINE, Ovid MEDLINE, EMBASE, and Cochrane Library databases were searched with a strategy combining MeSH and free text terms. Findings: The literature review included 364 articles focusing on impetigo, skin abscess, and cellulitis/orbital cellulitis. The articles included for quality assessment according to the GRADE methodology for impetigo comprised 5 RCTs and 1 observational study; for skin abscess, 10 RCTs and 3 observational studies were included; for cellulitis and erysipelas, 5 RCTs and 5 observational studies were included; and for orbital cellulitis, 8 observational studies were included. Recommendations were formulated according to 4 grades of strength for each specific topic (impetigo, skin abscesses, cellulitis, and orbital cellulitis). Where controversies arose and expert opinion was considered fundamental due to lack of evidence, agreement according to Delphi consensus recommendations was included. Implications: Based on a literature review and on local epidemiology, this article offers practical suggestions for use in both ambulatory and hospital settings for managing the most common bacterial SSTIs.

KW - abscess

KW - cellulitis

KW - children

KW - impetigo

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=85061597875&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061597875&partnerID=8YFLogxK

U2 - 10.1016/j.clinthera.2019.01.010

DO - 10.1016/j.clinthera.2019.01.010

M3 - Review article

C2 - 30777258

AN - SCOPUS:85061597875

VL - 41

SP - 532-551.e17

JO - Clinical Therapeutics

JF - Clinical Therapeutics

SN - 0149-2918

IS - 3

ER -