Skin and Soft Tissue Infections in Young Infants

WMJ. 2023 May;122(2):105-109.

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.

MeSH terms

  • Cellulitis / complications
  • Cellulitis / drug therapy
  • Child
  • Fever
  • Humans
  • Infant
  • Infant, Newborn
  • Retrospective Studies
  • Soft Tissue Infections* / drug therapy
  • Soft Tissue Infections* / epidemiology