P-747. Predictive Factors of Poor Outcomes in Non-Necrotizing Bacterial Dermohypodermitis: A Retrospective Study

TL;DR

This study identifies age over 65, obesity, and chronic venous insufficiency as risk factors for poor outcomes in non-necrotizing bacterial dermohypodermitis patients.

Contribution

The study identifies novel independent predictors of unfavorable outcomes in non-necrotizing bacterial dermohypodermitis patients.

Findings

82.6% of patients had a favorable outcome with defervescence and local improvement.

Age >65 years, obesity, and chronic venous insufficiency were independent predictors of unfavorable outcomes.

Recurrence occurred in 9.9% of cases, but factors like diabetes or prior episodes were not significant.

Abstract

Non-necrotizing bacterial dermohypodermitis (NBDH) is a common cause of hospitalization, typically responding well to appropriate antibiotic therapy. However, in some cases, the course may be complicated by local or systemic infectious events, potentially affecting prognosis. We aimed to describe the clinical course and identify predictive factors of unfavorable outcomes in patients hospitalized with NBDH.

We conducted a retrospective study including adult patients admitted for NBDH in the Infectious Diseases Department of Hedi Chaker University Hospital (Sfax, Tunisia) between January 2015 and December 2024. A favorable outcome was defined by defervescence within 72 hours and improvement or resolution of local signs within 5 days. An unfavorable outcome was defined as lack of clinical improvement after 5 days, or the occurrence of complications (e.g., sepsis, necrosis, abscess) or death

A total of 115 patients were included (mean age: 59 ± 16 years; 52.2% female). A cutaneous portal of entry was identified in 47% of cases. Empirical antibiotic therapy was mainly based on amoxicillin–clavulanate plus clindamycin (34.8%). Microbiologically guided adjustment was required in 8 cases. Surgical intervention was necessary in 5 cases. Mean antibiotic duration was 14 ± 7.2 days. Overall, 82.6% of patients had a favorable outcome. Independent predictors of unfavorable outcome included age >65 years (p=0.0056), obesity (p=0.008), and chronic venous insufficiency (p=0.052). Female sex (p=0.63), diabetes (p=0.523), and prior episodes of NBDH (p=0.413) were not significantly associated. Recurrence occurred in 9.9% of cases.

Early identification of risk factors such as advanced age, obesity, and venous insufficiency is essential for optimizing NBDH management and improving patient outcomes

All Authors: No reported disclosures