TY - JOUR
T1 - Common Community-acquired Bacterial Skin and Soft-tissue Infections in Children: an Intersociety Consensus on Impetigo, Abscess, and Cellulitis Treatment
AU - Society, Italian Pediatric Infectious Diseases
AU - Society, the Italian Pediatric Dermatology
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
U2 - 10.1016/j.clinthera.2019.01.010
DO - 10.1016/j.clinthera.2019.01.010
M3 - Article
VL - 41
SP - 532-551.e17
JO - Clinical Therapeutics
JF - Clinical Therapeutics
SN - 0149-2918
IS - 3
ER -