On the pathophysiology and management of cellulitis

Cellulitis is a bacterial skin and soft tissue infection. It is one of the most common infections requiring hospitalization, and one of the most common reasons for prescribing antibiotics. Despite the fact that it is a very visible infection, the underlying etiology is poorly understood. Many patients experience recurrences after the initial infection. Even though we have effective treatment options, studies on the most optimal or effective treatment are scarce. Recent concerns regarding antibiotic resistance have prompted studies to evaluate the minimum effective treatment duration in order to reduce antibiotic consumption. Reducing antibiotic consumption should lower the selective pressure that drives antibiotic resistance development. This thesis contains several studies. The most prominent one is a trial comparing the standard antibiotic therapy duration with a shorter therapy duration in patients hospitalized with cellulitis. Furthermore, current evidence on risk factors and etiology have been bundled into a novel model for the development of cellulitis. The skin microbiota of cellulitis patients has been analyzed in an effort to find correlations between aspects of the skin microbiota and the causative agent or disease characteristics. Changes in the coagulation and fibrinolysis system during cellulitis have been investigated. Finally, it shows the characteristics, clinical management and outcomes of a group of patients with cellulitis on the intensive care units. Thus, this thesis is on the pathophysiology and management of cellulitis.