Antibiotic Prophylaxis May Help Prevent Recurrent Cellulitis

HealthDay News — Antibiotic prophylaxis can prevent recurrence of cellulitis, according to a review published online in the Cochrane Library.

Adam Dalal, MD, from Beilinson Hospital in Petah Tikva, Israel, and colleagues conducted a systematic literature review to assess the beneficial and adverse effects of antibiotic prophylaxis or other prophylactic interventions for prevention of recurrent episodes of cellulitis in 6 trials with 573 participants. Five trials assessed antibiotic prophylaxis in patients with cellulitis of the legs.

The researchers found that antibiotic prophylaxis correlated with reduced risk of recurrence compared with no treatment or placebo (risk ratio [RR], 0.31; 95% CI, 0.13-0.72) based on data from 5 trials. 

Compared with no treatment or placebo, antibiotic prophylaxis decreased the cellulitis incidence rate (RR, 0.44; 95% CI, 0.22-0.89) and significantly decreased the rate until the next episode of cellulitis (hazard ratio [HR], 0.51; 95% CI, 0.34-0.78). After prophylaxis had been stopped, the protective effects of antibiotics did not last for risk of cellulitis recurrence (RR, 0.88; 95% CI, 0.59-1.31), incidence rate of cellulitis (RR, 0.94; 95% CI, 0.65-1.36), or rate until next cellulitis episode (HR, 0.78; 95% CI, 0.39-1.56). There were no significant differences in adverse effects or hospitalization between antibiotic and no treatment or placebo.

“Larger, high-quality studies are warranted, including long-term follow-up and other prophylactic measures,” the authors write.

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Dalal A, Eskin-Schwartz M, Mimouni D, et al. Interventions for the prevention of recurrent erysipelas and cellulitis. Cochrane Database Syst Rev. 2017;6:CD009758.