Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
J Microbiol Immunol Infect. 2017 Oct;50(5):613-618. doi: 10.1016/j.jmii.2015.08.008. Epub 2015 Sep 9.
BACKGROUND/PURPOSE: Recurrent cellulitis is an important clinical issue but the optimal strategy for prophylaxis is not determined. Intramuscular benzathine penicillin at a 4-week interval had been adopted in our hospital and the study was conducted to evaluate the efficacy.
From January 1, 2009 to May 31, 2013, all patients aged ≥ 18 year, with a history of recurrent cellulitis and having received at least three shots of intramuscular benzathine penicillin for prophylaxis were retrospectively recruited for analysis. Two treatment periods (prophylaxis period and nonprophylaxis period) were defined. The effects of benzathine penicillin prophylaxis and patient characteristics on the incidence rate of recurrent cellulitis were analyzed using Poisson regression model.
A total of 72 patients were enrolled, including 26 (36.1%) men. The most common underlying conditions were past surgery at the proximal side of the affected limb (38, 52.8%), malignancy (31, 43.1%), and diabetes mellitus (24, 33.3%). The incidence rate of recurrent cellulitis in the prophylaxis period was 0.73 episode/patient-year, significantly lower than that of 1.25 episodes/patient-year in the nonprophylaxis period (p < 0.001). Tinea pedis was a significant factor associated with increasing incidence of recurrent cellulitis in our cohort.
Intramuscular benzathine penicillin at a 4-week interval may be an effective prophylactic strategy to reduce the incidence of cellulitis. Further studies are necessary to determine the factors associated with failure of prophylaxis as well as optimal individualized dosage and dosing interval of the prophylactic agent.
背景/目的：复发性蜂窝织炎是一个重要的临床问题，但最佳的预防策略尚未确定。我院采用每 4 周肌内注射苄星青霉素进行预防，本研究旨在评估其疗效。
本研究回顾性分析了 2009 年 1 月 1 日至 2013 年 5 月 31 日期间所有年龄≥18 岁、有复发性蜂窝织炎病史且至少接受过 3 次肌内注射苄星青霉素预防的患者。定义了两个治疗期（预防期和非预防期）。采用泊松回归模型分析苄星青霉素预防对复发性蜂窝织炎发生率的影响以及患者特征对其的影响。
共纳入 72 例患者，其中男 26 例（36.1%）。最常见的潜在疾病为受累肢体近端手术史（38 例，52.8%）、恶性肿瘤（31 例，43.1%）和糖尿病（24 例，33.3%）。预防期复发性蜂窝织炎的发生率为 0.73 例/患者-年，显著低于非预防期的 1.25 例/患者-年（p<0.001）。足癣是导致本队列复发性蜂窝织炎发生率增加的一个显著因素。
每 4 周肌内注射苄星青霉素可能是一种有效预防策略，可降低蜂窝织炎的发生率。需要进一步研究确定预防失败的相关因素以及预防药物的最佳个体化剂量和给药间隔。
