Evidence map›Paper›PMID 39614879›Full record

SynthesisArchives of dermatological research2024

Diagnostic stewardship and dermatology consultation in cellulitis management: a systematic literature review and meta-analysis.

Vivian Lin, Gustavo Yano Callado, Isabele Pardo, Maria Gutfreund, Mariana Kim Hsieh, Andrea Mendes Rodrigues Pereira, Bernice Y Kwong, Maria Aleshin, Marisa Holubar, Jorge L Salinas and 2 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Archives of dermatological research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

12 authors.

Vivian LinFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. vivianlin0102@gmail.com.
Gustavo Yano CalladoFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Isabele PardoFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Maria GutfreundFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Mariana Kim HsiehFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Andrea Mendes Rodrigues PereiraFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Bernice Y KwongStanford University, Stanford, CA, USA.
Maria AleshinStanford University, Stanford, CA, USA.
Marisa HolubarStanford University, Stanford, CA, USA.
Jorge L SalinasStanford University, Stanford, CA, USA.
Daniel J DiekemaDepartment of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Alexandre R MarraFaculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cellulitis is a common skin infection often requiring antibiotic treatment. However, misdiagnosis and inappropriate antibiotic use contribute to antibiotic resistance and healthcare costs. We aimed to evaluate the impact of dermatology consultation on treatment modification in patients with suspected cellulitis and to determine whether dermatologists' evaluation can be used as a reference to diagnose suspected cellulitis. We explored MedLine (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane CENTRAL, Web of Science, and Scopus and Embase, including publications from database inception to July 25, 2023. Studies were included if they evaluated treatment modifications involving the use of antibiotics for patients with suspected cellulitis with and without dermatology consultation. We excluded comments or reviews, pilot studies, and studies without a non-dermatology control group, treatment modifications, the use of antibiotics, or patients with cellulitis. Of the 49 full-text articles, 14 studies met the selection criteria.This systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Of five independent reviewers (GYC, IP, MG, MKH, and AMRP), two abstracted data for each article using a standardized abstraction form. We used the Downs and Black scale to evaluate study quality. Subgroup analysis was conducted regarding readmission rate within 30 days for two independent populations seen by a non-dermatologist physician or a dermatologist. We employed random-effects models to obtain pooled mean differences. Heterogeneity was assessed using the I-squared value. The impact of dermatology consultation on treatment modification involving antibiotics in patients with suspected cellulitis and readmission rates in 30 days. Dermatology consultation changed initial treatment plans involving antibiotics from 47 to 96% of the time, improving diagnostic accuracy and, consequently, antibiotic stewardship of cellulitis. Dermatology consultation was not significantly associated with lower readmission rates in 30 days (pooled OR = 0.56, 95% CI: 0.25 to 1.25, I2 = 0%). Dermatology consultation in patients with suspected cellulitis may improve diagnosis and management, thereby reducing antibiotic misuse, unnecessary tests, and prolonged hospitalizations.

Indexed as

Anti-Bacterial AgentsCellulitisDermatologyReferral and ConsultationAntimicrobial StewardshipHumansAnti-Bacterial AgentsAntibiotic useCellulitisDermatologyDiagnostic stewardshipPseudocellulitisTeledermatology

Identifiers

PMID39614879

What OpenQuestion holds

Textmetadata
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.