2 episodes of cellulitis and been given antibiotics but the redness doesn't seem to be improving?

Understanding Persistent Cellulitis and Antibiotic Effectiveness

What is Cellulitis?

Cellulitis is a common bacterial skin infection that typically affects the deeper layers of the skin and the subcutaneous tissues. It often manifests as a red, swollen area that is hot and tender to the touch. The condition usually affects the lower legs, but it can occur anywhere on the body. The primary bacteria responsible for cellulitis are Streptococcus and Staphylococcus.

Typical Treatment with Antibiotics

In the United Kingdom, the standard treatment for cellulitis involves administering antibiotics, either orally for mild cases or intravenously for more severe cases. Common antibiotics prescribed include flucloxacillin, cephalexin, or clindamycin. Usually, patients see an improvement in symptoms within a few days of starting antibiotics. The total antibiotic course typically lasts from 5 to 14 days, depending on the severity and the patient's response to the treatment.

Why Might Cellulitis Redness Not Improve?

Persistent redness in cellulitis despite antibiotic treatment can be concerning. Several factors could contribute to this issue: 1. **Incorrect Diagnosis**: Sometimes, what seems like cellulitis may actually be another condition such as deep vein thrombosis, contact dermatitis, or even chronic venous insufficiency, which requires a different treatment approach. 2. **Resistant Bacteria**: The bacteria causing the cellulitis might be resistant to the prescribed antibiotics. MRSA (Methicillin-resistant Staphylococcus aureus) is a known resistant strain that may cause standard treatments to fail. 3. **Inadequate Dosage or Duration**: The antibiotics dosage may not be strong enough, or the course may not be long enough to fully eradicate the infection. 4. **Underlying Conditions**: Patients with weakened immune systems or conditions like diabetes may find it harder for their bodies to respond to treatment quickly. 5. **Deep-seated Infections**: Sometimes, the infection could be more deeply rooted than initially thought, requiring more aggressive treatment or even surgical intervention to drain abscesses or remove infected tissue.

When to Seek Further Medical Advice

If you have been treated for cellulitis with antibiotics and see no improvement, or if the symptoms are worsening, it is crucial to seek further medical advice. Immediate medical attention is necessary if you experience high fever, increased pain, spreading redness, or signs of systemic infection like chills and rapid heartbeat. In the UK, visiting your GP or contacting the NHS 111 service can provide additional guidance and support. They may recommend further diagnostic tests, a different antibiotic, or referral to a specialist for more intensive treatment.

Conclusion

Persistent redness in cellulitis despite antibiotic treatment warrants further investigation to correctly diagnose and treat the condition. Always follow up with healthcare professionals if your symptoms do not improve, ensuring the best care and effective resolution of the infection.