PAD-C Cohort V1.0
Research type
Research Study
Full title
The Personalised Antibiotic Duration for Cellulitis (PAD-C) Cohort Study
IRAS ID
295690
Contact name
Martin Llewelyn
Contact email
Sponsor organisation
University of Sussex
Duration of Study in the UK
3 years, 2 months, 1 days
Research summary
Summary of Research
Cellulitis is an increasingly common and unpleasant bacterial infection of the skin, usually affecting the legs. Patients experience pain and swelling, loss of mobility, fever, and chills. Patients may be left with chronic skin damage and 1 in 5 experience recurrences.
Cellulitis is treated with antibiotics. We know which antibiotics work for treating cellulitis, but we are less clear as to how long treatment should be for. As a result, many patients get much longer antibiotic treatment than they need. This exposes them to the risks of taking unnecessary antibiotics.
We want to find out what features of individual patients predict how likely they are to make a good, sustained recovery from cellulitis. These may include medical conditions a patient already has and how they respond to the first few days of their antibiotic treatment, such as changes in their skin temperature.
We will invite patients who are being treated in hospital for cellulitis to take part. Patients will be followed for 3-6 months to collect information about them and see what happens to them. We will also compare three devices for measuring skin temperature to see which one works best. This information will be used to help develop a set of rules that doctors can use to guide the length of antibiotic treatment. This should benefit future patients with cellulitis by ensuring they receive the amount of antibiotics they need and no more.
This research has been discussed with a group of people that have previously had cellulitis. This group helped to design the study and will continue to advise on key parts of the project. The results will be shared with patients, the wider public, and healthcare professionals, using social media, engagement events, scientific journals, and meetings. The research is funded by the National Institute for Health Research
Summary of Results
Cellulitis is a common skin infection. It is treated with antibiotics. Doctors often prescribe antibiotics for longer than needed. This is because there is no clear way of knowing when a someone has had enough treatment. This puts patients at risk of excess antibiotic use.Our study was designed and reviewed with help from five patients with previous leg cellulitis. Just over 200 adults with cellulitis of the leg or foot took part. All participants attended hospital in Sussex.
We looked at two main questions.
First, we tested a scoring system using routine details such as age and other health conditions to predict who is more likely to get cellulitis again. The score worked well at identifying people at higher risk of needing hospital care again for cellulitis. Looking at a patient’s early improvement after starting antibiotics, such as changes in swelling, pain, or blood tests, did not improve how well the score worked.
Second, we measured the temperature of the affected skin using different handheld devices that do not touch the skin. Skin temperature generally fell as patients recovered, but day-to-day changes were small. We also found that different devices gave different results. A thermal imaging camera showed the most promise for future research.
Overall, this research suggests that information available at the start of illness is useful for predicting whether someone will get cellulitis again. More research is needed to find out how skin temperature monitoring can guide individual treatment decisions.
REC name
East of Scotland Research Ethics Service REC 2
REC reference
21/ES/0048
Date of REC Opinion
23 Apr 2021
REC opinion
Favourable Opinion