Cellulitis secondary prevention

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.

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]