Factors Influencing Maternal Compliance with Iron and Folic Acid Supplements among Pregnant Women at a Tertiary Care Hospital
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Abstract
Background: Cellulitis is a common skin and soft tissue infection, and antibiotics are used in almost all cases. Nevertheless, whether surgery (incision and drainage, debridement) is helpful, especially in cases of abscess or in those that respond poorly to antibiotics, should be investigated. The medical management was compared with surgical intervention plus antibiotics for treating cellulitis patients in this systematic review and meta-analysis. Methods: This study was conducted according to the PRISMA guidelines. MEDLINE, EMBASE and Cochrane Central were searched for studies conducted between 2007 and March 2026 that compared medical management (antibiotics only) versus surgical intervention (incision and drainage or debridement) plus antibiotics in patients with cellulitis or skin abscess. The primary outcomes: treatment success (clinical cure at 7–14 days), length of hospital stay, and adverse events. Random-effects meta-analysis (DerSimonian-Laird) was used to pool risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). Heterogeneity was assessed using I². Results: Seven studies (3 randomized controlled trials, 2 retrospective cohorts, 2 systematic reviews) involving 2,632 patients were included. Surgical treatment combined with antibiotics modestly improved the rate of treatment success in the combined analysis of two high‑quality randomized controlled trials: RR 1.15 (95% CI 1.06, 1.24; I² = 0%). Another trial did not show positive effects of antibiotics (cure rate 84.1% with antibiotics vs 90.5% with placebo). One cohort study found that the length of hospital stay was increased by 1 day with surgery (MD +1 day). According to findings of a systematic review, conservative treatment in paediatric odontogenic cellulitis resulted in the success rates of 75-95%. Conclusion: In patients with skin abscesses, adding antibiotics to incision and drainage provides a modest improvement in treatment success, but I&D alone achieves high cure rates (>80–90%). Medical management alone (without drainage) is not recommended for drainable abscesses. Further research is needed to define subgroups that benefit most from adjunctive antibiotics
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