Cellulitis Optimal Antibiotic Treatment
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Flucloxacillin Only Product in Oral Dose Form, Placebo Only Product in Oral Dose Form.
- Who it may be relevant to
- Registry conditions: Cellulitis of Leg. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United Kingdom
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
A Blinded, Non-inferiority Phase III Trial of 5 Versus 7 Days of Oral Flucloxacillin in Primary Care Patients With Lower Limb Cellulitis
Overview
To determine whether a short course of oral flucloxacillin (5 days) is non-inferior to a standard course (7 days) in terms of pain over days 6-14 (indicative of persistence or recurrence associated with the symptoms of most importance to patients) in adults with cellulitis of the leg presenting in primary care.
Detailed description
Cellulitis is a deep infection of the skin and subcutaneous tissues and most often occurs in the legs. It is a painful condition that is associated with inflammation and swelling of the site, and often systemic symptoms such as fever, headache, muscle aches, malaise, and fatigue. Patients report feeling unwell and that it has a significant impact on their mobility and ability to carry out their usual activities. NICE guidelines recommend oral flucloxacillin 500-1000 mg four times daily for 5-7 days as first-line treatment for most patients with cellulitis in the community, but most prescriptions are dispensed for a 7-day course. We will be assessing the effectiveness and safety of a 5-day treatment vs. the standard 7-day treatment. We also aim to evaluate the cost-consequences of a shorter course from an NHS and personal perspective. Participants will be randomly allocated to one of two groups. In addition to usual care, participants will either be assigned to a 5-day oral flucloxacillin course or a standard 7-day flucloxacillin course. Participants will be prescribed a 5-day course of oral flucloxacillin, and two additional tablets will be posted to the participants which will either be the antibiotic or a placebo tablet. Participants will be asked to fill out daily questionnaires and express their experiences with the shortened course and taking part in the trial.
Interventions
- Drug Flucloxacillin Only Product in Oral Dose Form
Patients will be prescribed flucloxacillin 500mg QDS for 5 days followed by blinded flucloxacillin 500mg for 2 days, reaching a total of 7 days of antibiotic treatment - Drug Placebo Only Product in Oral Dose Form
Patients will be prescribed flucloxacillin 500mg QDS for 5 days followed by a blinded placebo for 2 days, reaching a total of 5 days of antibiotic treatment
Primary outcome measures
- Pain assessment [Time frame: Days 7-16]
Secondary outcome measures (10)
- Use of additional antibiotics [Time frame: Up to day 28]
- Patient-reported assessment of how well they are feeling [Time frame: Days 6-14]
- Health related quality of life [Time frame: Days 6-14]
- Health related quality of life used to estimate Quality Adjusted- Life Years (QALYs) [Time frame: Days 6-14]
- Leg swelling and warmth [Time frame: Day 7, 14, 21, 28]
- Time until self-reported recovery [Time frame: Day 7, 14, 21, 28]
- Time until self-assessed extent of cellulitis starts to reduce (with no subsequent increase) [Time frame: Day 7, 14, 21, 28]
- Hospital admissions [Time frame: 12 months]
- Recurrent cellulitis episodes over 12 months (number of episodes) [Time frame: 12 months]
- Complications over 12 months [Time frame: 12 months]
Eligibility criteria
Inclusion criteria
- Must be aged 18 years or older
- Currently showing symptoms of cellulitis (such as pain, tenderness, redness, other change in skin color, warmth to touch) in one leg for 10 days or less
- Pain rated as 3/10 or higher on a numerical rating scale (0-10) at baseline assessment
- Be willing to be randomized to either trial arm (5-day or 7-day treatment)
- Able to complete trial procedures in the English language.
Exclusion criteria
- Have penicillin allergy
- Have bilateral cellulitis
- Have had antibiotics for cellulitis within the past month
- Have post-operative cellulitis (within 30 days of operative procedures on the same leg)
- Have cellulitis resulting from human/animal bite injury
- Have Cellulitis associated with chronic (>6 weeks) leg ulceration
- Require immediate hospital admission or out-patient intravenous antibiotic therapy
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Quadruple blind
- Primary purpose
- Treatment
Study locations
United Kingdom · 1 center
- Royal South Hants Hospital — Southampton
Identifiers
NCT: NCT05584007 · ERGO 67073