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Cellulitis is both very common and very commonly misdiagnosed: Recent studies have shown that 30% to 60% of patients with presumed cellulitis actually have something else (NEJM JW Gen Med Apr 15 2023 and J Hosp Med 2023; 18:254). That confusion has muddied clinical expectations for patients who really do have cellulitis — how quickly should these patients respond to therapy?
British researchers tabulated responses to treatment among 247 adults (mean age, 52; 67% men) with confirmed lower-extremity cellulitis who were enrolled in a treatment trial of 7 to 10 days of a β-lactam drug, with or without clindamycin. Between baseline and day 5, surface area of affected skin shrank by 34%; by day 10, the affected area had shrunk by ≈55%. Swelling le…