Secondary prevention of cellulitis: A systematic review

Area of Science:

• Infectious Diseases
• Dermatology
• Public Health

Background:

• Cellulitis is a common bacterial skin infection with frequent recurrence.
• Antibiotics are the primary treatment, and prophylaxis prevents recurrence.
• Evidence for non-antibiotic interventions targeting risk factors for secondary prevention is limited.

Purpose of the Study:

• To systematically review evidence on managing risk factors for recurrent limb cellulitis.
• To evaluate interventions beyond antibiotic prophylaxis.

Main Methods:

• Systematic review of studies on cellulitis risk factor management (excluding antibiotic prophylaxis).
• Searched five databases (MEDLINE, Scopus, Web of Science, CINAHL, EMBASE) from 1996 to June 2024.
• Narrative synthesis and quality assessment of 25 eligible studies out of 1,116 screened papers.

Main Results:

• Lymphoedema management, especially with compression therapy, consistently reduced cellulitis recurrence.
• One randomized controlled trial was identified among the included studies.
• No studies linked the management of other risk factors (e.g., tinea, ulcers) to cellulitis recurrence.

Conclusions:

• Strong evidence supports lymphoedema management for preventing cellulitis recurrence.
• Research on managing other risk factors, such as skin integrity issues, is lacking.
• Further studies are needed to support non-antibiotic strategies for cellulitis prevention.