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Antibiotic prophylaxis for preventing recurrent cellulitis: a systematic review and meta-analysis
Choon Chiat Oh1, Henry Chung Hung Ko2, Haur Yueh Lee1
1Department of Dermatology, Singapore General Hospital, Singapore.
The Journal of Infection
|March 1, 2014
Summary
Antibiotic prophylaxis significantly reduces recurrent cellulitis episodes. Further research is needed to optimize antibiotic type, dosage, and duration for prophylaxis in specific patient groups.
Area of Science:
- Infectious Diseases
- Dermatology
- Pharmacology
Background:
- Recurrent cellulitis is common after an initial episode.
- The efficacy of antibiotic prophylaxis for preventing recurrence is debated.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of antibiotic prophylaxis in preventing recurrent cellulitis compared to no prophylaxis.
Main Methods:
- Systematic review and meta-analysis of five randomized controlled trials (n=535).
- Included patients aged 16+ with one or more prior cellulitis episodes.
- Primary outcome: recurrence of cellulitis; secondary outcomes: time to recurrence, quality of life, adverse events.
Main Results:
- Antibiotic prophylaxis reduced recurrent cellulitis by 54% (Risk Ratio: 0.46; 95% CI: 0.26-0.79).
- 8% of patients on prophylaxis and 18% of controls experienced recurrence.
- No severe adverse effects were reported; methodological heterogeneity existed across studies.
Conclusions:
- Antibiotic prophylaxis is effective in preventing recurrent cellulitis.
- Future research should focus on optimal antibiotic regimens and identifying patient subgroups most likely to benefit.
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