Cellulitis, recurrent
[NEJM 2013;368: 1695-703, Clin Infect Dis 2014;59:147-59.]
- Review differential diagnosis of cellulitis.
- Identify and treat predisposing conditions, e.g. edema, obesity, eczema, venous insufficiency, toe web intertrigo.
- Prophylactic antibiotics could be considered in patients who have ≥ 3 episodes of unilateral cellulitis per year despite attempts to modify predisposing conditions.
Usual Pathogens
ß-haemolytic Streptococci
Prophylaxis
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Penicillin VK | 250mg PO bid | Prolonged prophylaxis may be required if predisposing conditions cannot be modified. |
| or | ||
| Benzathine penicillin | 1.2MU IM q4weeks | Prolonged prophylaxis may be required if predisposing conditions cannot be modified. |
Penicillin allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Azithromycin | 250mg PO daily | Prolonged prophylaxis may be required if predisposing conditions cannot be modified. |
| or | ||
| Clarithromycin | 500mg PO daily | Prolonged prophylaxis may be required if predisposing conditions cannot be modified. |