Cellulitis: no clear difference between ofloxacin and cephalexin.

Clinical bottom line (level 1b-)

  1. There were no clear differences between ofloxacin and cephalexin for treatment of skin and soft tissue infections.
Powers: Southern Medical Journal 1991; 84 (11): 1313-1315
Expires November 2004

The study

Unblinded ?concealed randomised trial with intention-to-treat
Setting: emergency department, university hospital, USA

72 patients (aged range 18 to 57 years, 50% male) mild to moderate skin or soft-tissue infections (63% with abscess, 19% cellulitis, 15% with wound infection, and impetigo in 3%)

Excluded if
  • <18 years old
  • pregnant
  • severe liver or renal dysfunction
  • clinical evidence of serious infection necessitating hospitalisation or parenteral therapy


    • Control Group: (n = 34, 34 analysed): cephalexin 500 mg po bid (phase I - 46 patients); cephalexin 500 mg po qid (phase II - 26 patients)
    Experimental Group: (n = 38, 38 analysed): ofloxacin 300 mg po bid (phase I - 46 patients); ofloxacin 400 mg po bid (phase II - 26 patients)

    100% followed for 2 days

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    persistence of cellulitis 2 days 1
    (2.94%)    		 0
    (0.00%)    		 100%
    (% to %)    		 2.94%
    (-2.74% to 8.62%)    		 34
    (NNT = 12 to infinity;
    NNH = 37 to infinity)

  • Culture results - S. aureus (43%), no pathogen (37%), streptococci (7%), enterobacteriaceae (7%), Strep. species (4%), enterococci (2%).
  • Costs described in study - ofloxacin US $50 to 95, cephalexin $20 to $37 .

    • Comments

    1. Two phases to study - note the change in dosage.

    Citation

    1. Powers RD, : Soft tissue infections in the emergency department: the case for the use of 'simple' antibiotics. Southern Medical Journal 1991; 84 (11): 1313-1315
    Search Terms: cellulitis and therapy
    Contributor: John Epling and Chris Ball, November 2000
    Reviewer:

    Clinical Question.
    Patient skin and soft tissue infections
    Intervention or Exposure ofloxacin
    Comparison cephalexin
    Outcome persistence of cellulitis