Risk factors for antibiotic misuse for cellulitis in the emergency department through the SARS-CoV-2 pandemic: a single institute retrospective study

Abstract Cellulitis has a large burden on emergency departments (EDs) annually in the United States both in case volume and recurrence, causing antibiotic waste and poorer patient outcomes. To identify medical and demographic risk factors independently associated with antibiotic overprescription for cellulitis in the ED, we employed a retrospective cohort study utilizing electronic health records on patients with cellulitis-like symptoms in the ED from 2016 to 2023. Demographics, such as race, ethnicity, insurance status, and comorbidities were matched and reviewed alongside patient medical records to determine the over-prescribed cohort. A total of 1,283 (9%) of 13,530 patients were over-administered antibiotics for cellulitis-like-symptoms in the ED. Multivariate analysis showed that white, non-Latinx heritage (Relative risk (RR)=1.60; p