How is recurrent cellulitis treated?

Updated: Jun 14, 2019
  • Author: Thomas E Herchline, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

In the occasional patient with recurrent disease usually related to venous or lymphatic obstruction, the cellulitis is most often due to Streptococcus species, and penicillin G or amoxicillin (250 mg bid) or erythromycin (250 mg qd or bid) may be effective. [13] If tinea pedis is suspected to be the predisposing cause, treat with topical or systemic antifungals.

In a randomized, controlled trial in 274 patients who had experienced 2 or more episodes of cellulitis of the leg, a 12-month course of low-dose penicillin helped prevent recurrent cellulitis. The median time to first cellulitis recurrence was 626 days in the patients receiving penicillin (250 mg twice daily), versus 532 days in the placebo group. During the prophylaxis phase, 22% of the penicillin group (30 of 136 participants) had a recurrence, as compared to 37% of the placebo group (51 of 138 participants). However, the protective effect progressively diminished once the drug therapy ceased. [69, 70]


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