Comparison of short-course (5 days) and standard (10 days) treatment for uncomplicated cellulitis.
BACKGROUND
Cellulitis is a condition routinely encountered in the primary care setting. No previous study has compared a short (5 days) vs standard (10 days) course of therapy of the same antibiotic in patients with uncomplicated cellulitis.


METHODS
We performed a randomized, double-blind, placebo-controlled trial to determine if 5 days of therapy has equal efficacy to 10 days of therapy for patients with cellulitis. Of 121 enrolled subjects evaluated after 5 days of therapy for cellulitis, 43 were randomized to receive 5 more days of levofloxacin therapy (10 days total antibiotic treatment), and 44 subjects to receive 5 more days of placebo therapy (5 days of total antibiotic treatment). Levofloxacin was given at a dose of 500 mg/d. Subjects were not randomized if they had worsening cellulitis, a persistent nidus of infection, a lack of any clinical improvement, or abscess formation within the first 5 days of therapy. The main outcome measure was resolution of cellulitis at 14 days, with absence of relapse by 28 days, after study enrollment.


RESULTS
Eighty-seven subjects were randomized and analyzed by intention to treat. There was no significant difference in clinical outcome between the 2 courses of therapy (success in 42 [98%] of 43 subjects receiving 10 days of antibiotic, and 43 [98%] of 44 subjects receiving 5 days of antibiotic) at both 14 and 28 days of therapy.


CONCLUSIONS
In patients with uncomplicated cellulitis, 5 days of therapy with levofloxacin appears to be as effective as 10 days of therapy.
Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Tex., USA. matthew.hepburn@det.amedd.army.mil
Matthew J
MJ
Hepburn
David P
DP
Dooley
Peter J
PJ
Skidmore
Michael W
MW
Ellis
William F
WF
Starnes
William C
WC
Hasewinkle
D000704:Analysis of Variance; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002481:Cellulitis / Q000188:drug therapy*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage*; D018709:Statistics, Nonparametric
D000890:Anti-Infective Agents; D064704:Levofloxacin; D015242:Ofloxacin