Management of cellulitis: current practice and research questions.

Cellulitis is an acute, painful, and potentially serious infection of the skin and underlying tissue affecting approximately 1 in 40 people per year.1 Cellulitis presents as a painful, swollen, hot area, sometimes with systemic symptoms. Its impact can be considerable and can result in reduced quality of life and substantial periods of work absence.2 Cellulitis results in over 100 000 hospital admissions per year in England alone.Antibiotics are the mainstay of treatment. But antibiotic resistance is a major public health concern, and is a direct consequence of antibiotic use, particularly in primary care. Cellulitis and other soft-tissue infections account for 18% of antibiotic prescriptions outside inpatient hospital care, second only to respiratory conditions.3 What can be done to safely reduce antibiotic prescribing for cellulitis?The lower limb is most commonly affected by cellulitis and also the site where it is most commonly misdiagnosed. Because of the absence of confirmatory tests, the diagnosis of cellulitis is clinical, although the role of inflammatory markers, such as C-reactive protein, is under investigation. The differential diagnosis for red swollen lower limb includes deep vein thrombosis (DVT), venous eczema, venous …