- A systematic review and meta-analysis failed to determine the most effective treatment for cellulitis, citing low-quality evidence.
Why this matters
- The optimal antibiotic treatment for cellulitis is unclear.
- Cellulitis was the primary diagnosis in 35% of included studies.
- No evidence supported a specific antibiotic as most effective:
- Penicillin vs cephalosporins: risk ratio (RR), 0.98; 95% CI, 0.68-1.42.
- Cephalosporin A vs cephalosporin B: RR, 1.02; 95% CI, 0.96-1.09.
- β-lactam vs macrolide, lincosamide, or streptogramin: RR, 0.94; 95% CI, 0.85-1.04.
- Quinolone or vancomycin vs other antibiotic: RR, 1.04; 95% CI, 0.94-1.16.
- Linezolid vs other antibiotic: RR, 1.00; 95% CI, 0.95-1.05.
- Clindamycin vs trimethoprim sulfamethoxazole: RR, 1.05; 95% CI, 0.96-1.15.
- Antibiotics with activity against methicillin-resistant Staphylococcus aureus did not add to effectiveness (RR, 0.99; 95% CI, 0.92-1.06).
- Intravenous antibodies were inferior to oral antibiotics (RR, 0.83; P<.001 low-quality evidence>
- Longer treatment duration did not improve effectiveness (RR, 0.99; 95% CI, 0.94-1.04).
- 43 studies (5999 participants) were included in the meta-analysis.
- The primary outcome was the proportion of patients cured, improved, symptom-free, or symptom-reduced after treatment.
- Funding: None disclosed.
- Most included studies lacked clear endpoints.