Evidence map›Paper›PMID 31660410›Full record

ArticleOpen forum infectious diseases2019

Lessons Learned From a Randomized Controlled Trial of Short-Course Intravenous Antibiotic Therapy for Erysipelas and Cellulitis of the Lower Limb (Switch Trial).

Marcus C Clarke, Allen C Cheng, James Gd Pollard, Mark Birch, Raquel U Cowan, Jake A Linke, Aaron L Walton, N Deborah Friedman

Open access · goldAbstract read
In one paragraph

Article in Open forum infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Serological Responses toOpen forum infectious diseases · 2024
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Marcus C ClarkeDepartment of Infectious Diseases, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Allen C ChengSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
James Gd PollardDepartment of Infectious Diseases, Barwon Health, Geelong, Victoria, Australia.
Mark BirchDepartment of Infectious Diseases, Christchurch Public Hospital, Canterbury District Health Board, Christchurch, New Zealand.
Raquel U CowanDepartment of Infectious Diseases, Barwon Health, Geelong, Victoria, Australia.
Jake A LinkeDeakin University, School of Medicine, Geelong, Victoria, Australia.
Aaron L WaltonDepartment of Infectious Diseases, Barwon Health, Geelong, Victoria, Australia.
N Deborah FriedmanDepartment of Infectious Diseases, Barwon Health, Geelong, Victoria, Australia.
Barwon Health · AUCanterbury District Health Board · NZDeakin University · AUMonash University · AURoyal Hobart Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe diagnosis of cellulitis is made clinically without a gold standard diagnostic test, and cellulitis has many disease mimics. There is currently no consensus for optimal antimicrobial treatment duration or method of antimicrobial delivery.

methodsThis was a randomized controlled open-label multicenter trial to determine the safety and efficacy of 24 hours of intravenous (IV) therapy compared with ≥72 hours of IV therapy, both followed by oral therapy to a maximum of 7-10 days' duration for the treatment of lower limb cellulitis.

resultsOver 40 months, 80 patients were recruited. Thirty-nine patients were assigned to 24 hours of IV antibiotics and 41 to ≥72 hours of IV antibiotics. The mean duration (range) of IV antibiotics in the 24-hour group was 25.5 (17-40) hours, and in the ≥72-hour group it was 78 (41.5-210) hours. Three patients in the 24-hour arm and 4 patients in the ≥72-hour arm were excluded from the analysis due to withdrawal from the trial. Analysis of the remaining patients revealed that 6 patients (4 in the intervention arm and 2 in the control arm) did not achieve an adequate response to therapy. Only 1 patient experienced self-limiting adverse effects of treatment.

conclusionsThe noninferiority of short-course IV therapy cannot be determined from this trial. Challenges included resource limitations for recruitment, misdiagnosis, participant withdrawal, and subjective responses to therapy based on visual assessment by treating clinicians. Further studies are needed to determine if short-course IV therapy is a suitable treatment option. AUSTRALIA COUNCIL OF CLINICAL TRIALS REGISTRY NO: ACTRN12613001366741.

Indexed as

antibiotic therapycellulitiserysipelas

Identifiers

PMID31660410
PMCPMC6798252
OpenAlexW2965189473

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.