Recurrent Cellulitis: Who is at Risk and How Effective is Antibiotic Prophylaxis?

Overview

Journal Int J Gen Med

Publisher Dove Medical Press

Specialty General Medicine

Date 2022 Aug 19

PMID 35983462

Authors

Bin S Ong

Ravindra Dotel

Vincent Jiu Jong Ngian

Affiliations

Soon will be listed here.

Abstract

Recurrent cellulitis following successful treatment is common and prevention should be a major component in the management of cellulitis. Conditions that increase the risk of recurrence include chronic edema, venous disease, dermatomycosis and obesity. These risk factors should be actively managed as further episodes of cellulitis increases the risk of recurrence. The role of non-antibiotic measures is important and should be first-line in prevention. Antibiotic prophylaxis is effective, but its role is limited to non-purulent cellulitis where risk factors are appropriately managed.

Citing Articles

Recurrence of skin and soft tissue infections: identifying risk factors and treatment strategies.

Toschi A, Giannella M, Viale P Curr Opin Infect Dis. 2025; 38(2):71-77.

PMID: 39882704 PMC: 11872275. DOI: 10.1097/QCO.0000000000001096.

Chronic Cellulitis in Elephantiasis: A Rare Debilitating Phenomenon.

Singh S, Shukla R, Singh A, Acharya S Cureus. 2024; 16(7):e65855.

PMID: 39219932 PMC: 11364152. DOI: 10.7759/cureus.65855.

Development and validation of the Baseline Recurrence Risk in Cellulitis (BRRISC) score.

L A Cross E, Quan T, Hayward G, Walker A, Llewelyn M J Infect. 2023; 88(2):103-111.

PMID: 38128701 PMC: 11832457. DOI: 10.1016/j.jinf.2023.12.007.

Exploration of wound-related complications post-kidney transplantation.

Sun H, Liu K, Peng Z, Liu S Int Wound J. 2023; 21(4):e14578.

PMID: 38113325 PMC: 10961868. DOI: 10.1111/iwj.14578.

Profound and selective lymphopaenia in primary lymphatic anomaly patients demonstrates the significance of lymphatic-lymphocyte interactions.

Pearce J, Hadcocks L, Mansour S, van Zanten M, Jeffery S, Gordon K Front Immunol. 2023; 14:1279077.

PMID: 38022535 PMC: 10656747. DOI: 10.3389/fimmu.2023.1279077.

References

Vignes S, Dupuy A . Recurrence of lymphoedema-associated cellulitis (erysipelas) under prophylactic antibiotherapy: a retrospective cohort study. J Eur Acad Dermatol Venereol. 2006; 20(7):818-22. DOI: 10.1111/j.1468-3083.2006.01648.x. View

Jeng A, Beheshti M, Li J, Nathan R . The role of beta-hemolytic streptococci in causing diffuse, nonculturable cellulitis: a prospective investigation. Medicine (Baltimore). 2010; 89(4):217-226. DOI: 10.1097/MD.0b013e3181e8d635. View

Lim C, Davies A . Graduated compression stockings. CMAJ. 2014; 186(10):E391-8. PMC: 4081237. DOI: 10.1503/cmaj.131281. View

Haustein U, Biella U, Tausch I, Knoll H . [Treatment of chronic recurrent erysipelas with streptococcal vaccine]. Hautarzt. 1989; 40(4):215-21. View

Raff A, Kroshinsky D . Cellulitis: A Review. JAMA. 2016; 316(3):325-37. DOI: 10.1001/jama.2016.8825. View

Karppelin M, Siljander T, Aittoniemi J, Hurme M, Huttunen R, Huhtala H . Predictors of recurrent cellulitis in five years. Clinical risk factors and the role of PTX3 and CRP. J Infect. 2014; 70(5):467-73. DOI: 10.1016/j.jinf.2014.11.002. View

Norimatsu Y, Ohno Y . Predictors for readmission due to cellulitis among Japanese patients. J Dermatol. 2021; 48(5):681-684. PMC: 8248013. DOI: 10.1111/1346-8138.15771. View

Semel J, GOLDIN H . Association of athlete's foot with cellulitis of the lower extremities: diagnostic value of bacterial cultures of ipsilateral interdigital space samples. Clin Infect Dis. 1996; 23(5):1162-4. DOI: 10.1093/clinids/23.5.1162. View

Scheinfeld N . Obesity and dermatology. Clin Dermatol. 2004; 22(4):303-9. DOI: 10.1016/j.clindermatol.2004.01.001. View

10.

Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Fujioka Y . Lymphovenous Anastomosis for Morbidly Obese Patients with Lymphedema. Plast Reconstr Surg Glob Open. 2020; 8(5):e2860. PMC: 7572113. DOI: 10.1097/GOX.0000000000002860. View

11.

Kang H, Choi I, Park C, Lee K . Recurrent Cellulitis Associated with Acupuncture with Migratory Gold Threads. Ann Dermatol. 2021; 33(3):281-283. PMC: 8137335. DOI: 10.5021/ad.2021.33.3.281. View

12.

DiSipio T, Rye S, Newman B, Hayes S . Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol. 2013; 14(6):500-15. DOI: 10.1016/S1470-2045(13)70076-7. View

13.

Eriksson B, Jorup-Ronstrom C, Karkkonen K, Sjoblom A, Holm S . Erysipelas: clinical and bacteriologic spectrum and serological aspects. Clin Infect Dis. 1996; 23(5):1091-8. DOI: 10.1093/clinids/23.5.1091. View

14.

Raffetto J . Dermal pathology, cellular biology, and inflammation in chronic venous disease. Thromb Res. 2009; 123 Suppl 4:S66-71. DOI: 10.1016/S0049-3848(09)70147-1. View

15.

Theofiles M, Maxson J, Herges L, Marcelin A, Angstman K . Cellulitis in Obesity: Adverse Outcomes Affected by Increases in Body Mass Index. J Prim Care Community Health. 2015; 6(4):233-8. DOI: 10.1177/2150131915583659. View

16.

Bristow I, Spruce M . Fungal foot infection, cellulitis and diabetes: a review. Diabet Med. 2009; 26(5):548-51. DOI: 10.1111/j.1464-5491.2009.02722.x. View

17.

Webb E, Neeman T, Bowden F, Gaida J, Mumford V, Bissett B . Compression Therapy to Prevent Recurrent Cellulitis of the Leg. N Engl J Med. 2020; 383(7):630-639. DOI: 10.1056/NEJMoa1917197. View

18.

Tuttle M . Association Between Microbial Bioburden and Healing Outcomes in Venous Leg Ulcers: A Review of the Evidence. Adv Wound Care (New Rochelle). 2015; 4(1):1-11. PMC: 4281836. DOI: 10.1089/wound.2014.0535. View

19.

Sjoblom A, Eriksson B, Jorup-Ronstrom C, Karkkonen K, Lindqvist M . Antibiotic prophylaxis in recurrent erysipelas. Infection. 1993; 21(6):390-3. DOI: 10.1007/BF01728920. View

20.

Dale J, Walker M . Update on group A streptococcal vaccine development. Curr Opin Infect Dis. 2020; 33(3):244-250. PMC: 7326309. DOI: 10.1097/QCO.0000000000000644. View