Sheila Swartz, MD, MPH; Leah Cotter, MD; Anika Nelson, MD; Jian Zhang, PhD; Ke Yan, PhD; Michelle L Pickett, MD, MS
WMJ. 2023;122(2):105-109.
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ABSTRACT
Introduction: The management of young infants with skin and soft tissue infection is not well-defined.
Methods: We performed a survey study of pediatric hospital medicine, emergency medicine, urgent care, and primary care physicians to assess the management of young infants with skin and soft tissue infection. The survey included 4 unique scenarios of a well-appearing infant with uncomplicated cellulitis of the calf with the combination of age ≤ 28 days vs 29–60 days and the presence vs absence of fever.
Results: Of 229 surveys distributed, 91 were completed (40%). Hospital admission was chosen more often for younger infants (≤ 28 days) versus older infants regardless of fever status (45% vs 10% afebrile, 97% vs 38% febrile, both P < 0.001). Younger infants were more likely to get blood, urine, and cerebrospinal fluid studies (P < 0.01). Clindamycin was chosen in 23% of admitted younger infants compared to 41% of older infants (P < 0.05).
Conclusions: Frontline pediatricians appear relatively comfortable with outpatient management of cellulitis in young infants and rarely pursued meningitis evaluation in any afebrile infants or older febrile infants.