Cellulitis secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Measures to treat conditions predisposing to the recurrence of cellulitis include elevation of the extremities, compressive stockings, pneumatic pressure pumps, and diuretics. Prophylactic penicillin or erythromycin may be considered for frequent cellulitis episodes.

Secondary Prevention

Elevation of the extremities, compressive stockings, pneumatic pressure pumps, or diuretics can be used to reduce peripheral edema, which is a predisposing factor for recurrence. Patients should also receive therapy for interdigital maceration, dermatophytic infection (such as tinea pedis), stasis dermatitis, or trauma.[1] The skin should be well hydrated with emollients to avoid dryness and cracking. In patients with recurrent cellulitis despite these measures, benzathine penicillin (1.2 MU IM monthly), penicillin V (1 gm PO bid) or erythromycin (250 mg PO bid) may be effective in preventing subsequent attacks during prophylaxis.[2]


  1. Stevens, DL.; Bisno, AL.; Chambers, HF.; Everett, ED.; Dellinger, P.; Goldstein, EJ.; Gorbach, SL.; Hirschmann, JV.; Kaplan, EL. (2005). "Practice guidelines for the diagnosis and management of skin and soft-tissue infections". Clin Infect Dis. 41 (10): 1373–406. doi:10.1086/497143. PMID 16231249. Unknown parameter |month= ignored (help)
  2. Thomas, KS.; Crook, AM.; Nunn, AJ.; Foster, KA.; Mason, JM.; Chalmers, JR.; Nasr, IS.; Brindle, RJ.; English, J. (2013). "Penicillin to prevent recurrent leg cellulitis". N Engl J Med. 368 (18): 1695–703. doi:10.1056/NEJMoa1206300. PMID 23635049. Unknown parameter |month= ignored (help)