Interventions for cellulitis and erysipelas

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Limited evidence shows that macrolide and streptogramin are slightly better than penicillin for eliminating or reducing symptoms at the end of treatment for cellulitis, as well as indicating that oral antibiotics can be more effective than intravenous antibiotics.

Cellulitis and erysipelas are considered manifestations of the same condition, a skin infection associated with severe pain and systemic symptoms. This review uses the term ‘cellulitis’ to describe both conditions. The infection is usually treated with antibiotics; however, corticosteroids and physical treatments have also been used.  This review assesses the efficacy and safety of interventions for non‐surgically acquired cellulitis. Researchers selected randomised controlled trials comparing two or more different interventions for cellulitis. These included 25 studies with a total of 2488 participants, however no two trials investigated the same antibiotics. There was also no standard treatment regime used as a comparison. Oral antibiotics appeared to be more effective than antibiotics given into a vein for moderate and severe cellulitis. There is limited evidence that macrolide and streptogramin are slightly better than penicillin for reducing symptoms at the end of treatment for cellulitis. No firm conclusions can be drawn about which treatment is most effective because of insufficient data.

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