In general, we expand antibiotics too soon in cellulitis, ...
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In general, we expand antibiotics too soon in cellulitis, as clinical response (e.g. reduction in edema/erythema, decrease in WBC count, defervesence) can take 48-72 hours.

For patients who are not improving by 72H, in addition to “wrong bug/wrong drug” that would support switching antibiotics, also consider the following:

lack of source control (e.g. abscess, osteomyelitis)

bacteremia

vascular insufficiency (venous stasis or arterial insufficiency + inadequate elevation)

alternative diagnosis (e.g. venous stasis, drug reaction, etc.)

#EBM #ID #Management #Cellulitis #Timeline #Progression #PrematureEscalation
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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