Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Penicillin to prevent recurrent leg cellulitis
New England Journal of Medicine, Volume 368, No. 18, Year 2013
Notification
URL copied to clipboard!
Description
BACKGROUND: Cellulitis of the leg is a common bacterial infection of the skin and underlying tissue. We compared prophylactic low-dose penicillin with placebo for the prevention of recurrent cellulitis. METHODS: We conducted a double-blind, randomized, controlled trial involving patients with two or more episodes of cellulitis of the leg who were recruited in 28 hospitals in the United Kingdom and Ireland. Randomization was performed according to a computer-generated code, and study medications (penicillin [250 mg twice a day] or placebo for 12 months) were dispensed by a central pharmacy. The primary outcome was the time to a first recurrence. Participants were followed for up to 3 years. Because the risk of recurrence was not constant over the 3-year period, the primary hypothesis was tested during prophylaxis only. RESULTS: A total of 274 patients were recruited. Baseline characteristics were similar in the two groups. The median time to a first recurrence of cellulitis was 626 days in the penicillin group and 532 days in the placebo group. During the prophylaxis phase, 30 of 136 participants in the penicillin group (22%) had a recurrence, as compared with 51 of 138 participants in the placebo group (37%) (hazard ratio, 0.55; 95% confidence interval [CI], 0.35 to 0.86; P=0.01), yielding a number needed to treat to prevent one recurrent cellulitis episode of 5 (95% CI, 4 to 9). During the no-intervention follow-up period, there was no difference between groups in the rate of a first recurrence (27% in both groups). Overall, participants in the penicillin group had fewer repeat episodes than those in the placebo group (119 vs. 164, P=0.02 for trend). There was no significant between-group difference in the number of participants with adverse events (37 in the penicillin group and 48 in the placebo group, P = 0.50). CONCLUSIONS: In patients with recurrent cellulitis of the leg, penicillin was effective in preventing subsequent attacks during prophylaxis, but the protective effect diminished progressively once drug therapy was stopped. (Funded by Action Medical Research; PATCH I Controlled-Trials.com number, ISRCTN34716921.) Copyright © 2013 Massachusetts Medical Society.
Authors & Co-Authors
Thomas, Kim Suzanne
United Kingdom, Nottingham
University of Nottingham
Crook, Angela M.
United Kingdom, London
Medical Research Council
Nunn, Andrew J.
United Kingdom, London
Medical Research Council
Foster, Katharine A.
United Kingdom, Nottingham
University of Nottingham
Chalmers, Joanne R.
United Kingdom, Nottingham
University of Nottingham
Brindle, Richard J.
United Kingdom, Bristol
Bristol Royal Infirmary
Meredith, Sarah K.
United Kingdom, London
Medical Research Council
Reynolds, Nicholas J.
United Kingdom, Newcastle
Newcastle University
de Berker, David A.R.
United Kingdom, Bristol
Bristol Royal Infirmary
Mortimer, Peter S.
United Kingdom, London
St George’s, University of London
Williams, Hywel C.
United Kingdom, Nottingham
University of Nottingham
Statistics
Citations: 128
Authors: 11
Affiliations: 8
Identifiers
Doi:
10.1056/NEJMoa1206300
ISSN:
00284793
Research Areas
Disability
Environmental
Study Design
Randomised Control Trial
Cohort Study